The Volokh Conspiracy - The AMA, Licensing, and African-American Physicians:

The American Medical Association is reportedly going to apologize today for its history of discrimination against African American physicians. I doubt that this apology will include any reference to the fact that the AMA's control of the physician licensing process suppressed the supply of black doctors for decades. Here is a relevant excerpt from my book, Only One Place of Redress: African Americans, Labor Regulations and the Courts from Reconstruction to the New Deal (read reviews here):

Once the AMA took control of licensing procedures, state physician licensing laws began to have marked effects on the number of black doctors. Most important, states ... forced five of the seven existing black medical schools, which educated most black doctors, to close. ... [T]he charitable foundations that supported black medical schools cut off funds to these school, and instead directed their philanthropy to the two black medical schools that survived, Howard and Meharry. Even those two schools were in danger for a time of losing their accreditations.

If licensing officials had taken the interests of the black community to heart, they could have temporarily bent standards in order to allow the other black schools to catch up. Despite [Abraham] Flexner's [author of the influential Flexner Report on medical education] dismissal of these schools as worthless, approximately half of their graduates had been able to pass their states' licensing examinations, and several of their graduates became prominent physicians.

Alternatively, licensing authorities could have pressured the other medical schools to admit black students, or at least create parallel programs for blacks. But the AMA, which controlled the licensing process, was concerned mainly with the interests of its members, who were, by strict rule, all white. Most AMA members were indifferent to the shortage black physicians, and some southern white doctors resented even the minimal competition they received from blacks....

Moreover, there was opposition in the South to allowing blacks to serve as medical personnel at all. Mississippi authorities were reputed to routinely fail black physician and dentist candidates, especially if they were not from the South....

Meanwhile, ever-increasing pre-medical educational requirements made it difficult for students from impoverished backgrounds to achieve the financial wherewithal to attend medical school. Flexner argued that his recommendations for additional pre-medical education would not discourage poor students, because non-profit medical schools, subsidized by foundations and alumni, would be able to offer six years of education for the price that for-profit schools charged for four years of education. Apparently, Flexner ... was not familiar with the concept of opportunity costs....

Not surprisingly, after 1910, the percentage of black doctors, which had been rising, leveled off. Because of the medical establishment's attitude toward blacks, which ranged from indifference to hostility, as late as the 1940s over 80% of black medical students received their education at Howard and Meharry.

	[David Bernstein, July 10, 2008 at 8:02am] Trackbacks The AMA, Licensing, and African-American Physicians: The American Medical Association is reportedly going to apologize today for its history of discrimination against African American physicians. I doubt that this apology will include any reference to the fact that the AMA's control of the physician licensing process suppressed the supply of black doctors for decades. Here is a relevant excerpt from my book, Only One Place of Redress: African Americans, Labor Regulations and the Courts from Reconstruction to the New Deal (read reviews here): Once the AMA took control of licensing procedures, state physician licensing laws began to have marked effects on the number of black doctors. Most important, states ... forced five of the seven existing black medical schools, which educated most black doctors, to close. ... [T]he charitable foundations that supported black medical schools cut off funds to these school, and instead directed their philanthropy to the two black medical schools that survived, Howard and Meharry. Even those two schools were in danger for a time of losing their accreditations. If licensing officials had taken the interests of the black community to heart, they could have temporarily bent standards in order to allow the other black schools to catch up. Despite [Abraham] Flexner's [author of the influential Flexner Report on medical education] dismissal of these schools as worthless, approximately half of their graduates had been able to pass their states' licensing examinations, and several of their graduates became prominent physicians. Alternatively, licensing authorities could have pressured the other medical schools to admit black students, or at least create parallel programs for blacks. But the AMA, which controlled the licensing process, was concerned mainly with the interests of its members, who were, by strict rule, all white. Most AMA members were indifferent to the shortage black physicians, and some southern white doctors resented even the minimal competition they received from blacks.... Moreover, there was opposition in the South to allowing blacks to serve as medical personnel at all. Mississippi authorities were reputed to routinely fail black physician and dentist candidates, especially if they were not from the South.... Meanwhile, ever-increasing pre-medical educational requirements made it difficult for students from impoverished backgrounds to achieve the financial wherewithal to attend medical school. Flexner argued that his recommendations for additional pre-medical education would not discourage poor students, because non-profit medical schools, subsidized by foundations and alumni, would be able to offer six years of education for the price that for-profit schools charged for four years of education. Apparently, Flexner ... was not familiar with the concept of opportunity costs.... Not surprisingly, after 1910, the percentage of black doctors, which had been rising, leveled off. Because of the medical establishment's attitude toward blacks, which ranged from indifference to hostility, as late as the 1940s over 80% of black medical students received their education at Howard and Meharry.