In the antebellum period, the United States' framework for medical licensing collapsed.

What happened? (Hint: there are implications for today)

[a #medhistory thread]

Early medicine in the US was far more art and guesswork than science, and it was largely passed through an apprenticeship model.

Aspiring physicians learned by “reading and riding with the doctors.”

https://medicine.yale.edu/news/yale-medicine-magazine/the-physicians-apprentice/

Unfortunately, this laid the groundwork for something VERY similar to what is happening today -->

The phenomenon of popular knowledge was perhaps as accurate as that of experts spread like WILDFIRE in the early 1800s in the US.

Thing were about to get worse during the Jacksonian Era (1828–1840).

Tell me if this sounds like anyone you know...

"President Andrew Jackson inculcated a reverence for the wisdom of the common man and cast a skeptical eye on experts and authorities who they deemed more likely to protect their own interests than those of the average citizen."

https://meridian.allenpress.com/jmr/article/98/1/20/212503/The-History-of-the-Federation-of-State-Medical

At the same time as the fervent rise in what was later deemed "anti-intellectualism," there was a spike in minimalist approaches such as herbalism.

"Nature made the cure."

The Jacksonian era was also characterized by individualism and a lack of, or dismantling of, regulations...

and of course *this* lead to the rise of such things as Samuel Hahnemann's homeopathy.

The first half of the 19th century quite literally saw a collapse of medical regulations thanks to public distrust in medicine and a despot who sought to undermine public health regulations.

Remind you of anyone yet?

Keep reading, though, because eventually medicine pulled itself out of this mess, and if were going to survive Tr*mp, Pe*ce, and #COVID19, were going to have to do the same.

1. Physicians got organized.

Where the government failed to sufficiently protect the public, we stepped in and founded the AMA.

2. Physicians refocused priorities.

The Jacksonian era saw almost every state pull its licensing laws off the books. In order to get them BACK, physicians reframed licensing as a "genuine effort at protecting the public and the interests of independent educated professionals."

They did this by meeting people where they're at -->

Post-Jacksonian era physicians recognized the harm that the industrial age was doing to the working class in this country, and this made persuasive arguments for the physician as a promoter of public health.

It is also essential to remember that the flame Jackson dumped gas on was public distrust and confusion about medical care and medicine.

How do we avoid making those same mistakes? Open communication, for one. Better public health funding. Better education?