Defining the Physician's Duty: Medical Professionalization in America and the Politics of Prostitution Reform Activism, 1870s-1910s

Abstract

Historians have identified the late-nineteenth to early-twentieth centuries as a period of intensified professionalization in American medicine, marked by the growth of professional associations and specialization, the development of licensing standards, and efforts to improve medical education. This dissertation intervenes in that literature by moving beyond this focus on institutional structures to instead address how extra-professional intervention shaped professionalization processes. Focusing on physicians’ prostitution reform activism from the 1870s-1910s, this study demonstrates that professionalization was often the product of unplanned actions in unexpected areas of intervention, not of a clear plan with a predetermined direction. As doctors entered prostitution reform, confluences of circumstances and actions beyond physicians’ control generated opportunities that individuals exploited for many reasons besides professionalization, but nonetheless shaped how physicians claimed professional status and identity. This dissertation contends that to understand medical professionalization, it must be situated in its Christian, sexual, and imperial politics because it was at the crossroads of faith, gender, and empire that balances of power between groups of physicians, and with it their ability to shape the trajectory of their profession, could tilt. Prostitution reform activism thus became a key battleground upon which doctors worked collectively for expanded authority and power, even as they engaged in internecine conflicts over professional duty and its areas of social, political, moral, and spiritual purview. Attending to these relations of power reveals women physicians, eccentric male health reformers, military surgeons, venereal specialists, and other assumed-to-be marginal groups playing leading roles in defining the physician’s duty.