Black physicians in the Jim Crow South

Abstract

Black Physicians in the Jim Crow South. By Thomas J. Ward, Jr. (Fayetteville: University of Arkansas Press, 2003. Pp. xxiv, 368. Preface, acknowledgments, introduction, list of abbreviations, illustrations, notes, bibliography, index. $34.95.) This book illuminates the struggles between 1865 and 1964 of black physicians in a segregated society. Ward points out that conventional history of medicine is that of white medicine. Few know, for instance, that the world's first open-heart surgery was performed by an African American, Dr. Daniel Hale Williams, at Freedmen's Hospital in 1893. The costs of the increased professionalism that the American Medical Association (AMA) began seeking at the end of the nineteenth century by raising standards of medical education and licensure fell disproportionately on blacks, the poor, and women. The Flexner Report (1910) called for two years of college, four years in a medical school affiliated with a university, and a one-year internship at a teaching hospital. Some 46 of the nation's 155 medical schools in 1910 had closed or merged by 1920, including several proprietary black medical schools. Only the all-black medical schools Meharry and Howard University, along with Harvard and the University of Michigan, were open to African Americans. The thrust for fewer and doctors limited medical education to middle and upper-class males. Ward details how white philanthropists Julius Rosenwald, John D. Rockefeller, Andrew Carnegie, and James B. Duke supported black medical schools and hospitals. Yet there was implicit paternalism. These schools were funded to concentrate on basic medical skills rather than research or specialty training. If a black male overcame tremendous economic hurdles, with a separate and unequal educational background at every level, he failed state licensing examinations at six times the national average. Internships and residencies were severely limited. Even black graduates of Harvard and Michigan could not obtain hospital privileges in the South, except in all-black hospitals. In 1928, Mississippi had forty-two beds available to black physicians. Ward vividly describes black doctors' struggle to establish practices among the lowest economic stratum. He discusses the dynamics of competition for paying black middle-class patients, who might choose white physicians, believing them to be better trained. Black doctors gave away a large amount of medical care. The one small group who regularly paid black doctors were white abortion and venereal disease patients who did not want their problems known in their own communities. …