From Lancents to Laboratories: Medical Schools, Physicians, and Healthcare in the United States from 1870 to 1940

Persistent Link:
http://hdl.handle.net/10150/194977
Title:
From Lancents to Laboratories: Medical Schools, Physicians, and Healthcare in the United States from 1870 to 1940
Author:
Treber, Jaret Scott
Issue Date:
2005
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Healthcare in the United States experienced a remarkable transformation during the late 19th and early 20th centuries. While this transformation is well documented in descriptive historical accounts there are few empirical studies investigating the mechanisms through which reform was disseminated or the affects of the reform on healthcare. To this end, this dissertation examines four issues related to changes in the American healthcare industry during the early 1900's.Chapter 2 examines changes in medical education. This chapter provides a qualitative analysis of motivations behind the medical education reforms in America and an empirical analysis of the shakeout of medical schools that occurred from 1905 to 1920. Licensing laws and medical school reviews were found to have influenced exiting decisions of many medical schools. Reform of medical education in America was followed by a disproportionate decline of physician supply in rural areas. Along these lines, Chapter 3 provides a case study of the geographic distribution of physicians during the early 20th Century. Data on individual physicians was compiled to analyze variation in physician counts across counties and to investigate out-migration of rural county physicians. This analysis indicates physicians were drawn more and more to areas offering better financial opportunities, greater access to medical facilities, and more opportunity for professional contact.It is unclear to what extent patients initially benefited from the changes in medicine. Chapters 4 and 5 focus on one aspect of this issue by examining the impact of physicians on mortality rates. Chapter 4 utilizes the individual physician data from Chapter 3 to assess whether variation in physician counts explain variation in infant and non-infant mortality rates across counties. Estimates indicate that physicians were still unable to reduce mortality in the early 1920's. Chapter 5 focuses on the impact on maternal mortality resulting from the transition of childbirth during the first half of the 20th Century from the home to the hospital setting. Using hospital beds as a proxy for medical inputs, regression analysis revealed that the transition may have contributed to more maternal deaths until the introduction of sulfa drugs in the late 1930's.
Type:
text; Electronic Dissertation
Keywords:
Healthcare; Flexner; Medical Education; Physician Location; Physician Impact
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Economics; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Fishback, Price V.
Committee Chair:
Fishback, Price V.

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleFrom Lancents to Laboratories: Medical Schools, Physicians, and Healthcare in the United States from 1870 to 1940en_US
dc.creatorTreber, Jaret Scotten_US
dc.contributor.authorTreber, Jaret Scotten_US
dc.date.issued2005en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractHealthcare in the United States experienced a remarkable transformation during the late 19th and early 20th centuries. While this transformation is well documented in descriptive historical accounts there are few empirical studies investigating the mechanisms through which reform was disseminated or the affects of the reform on healthcare. To this end, this dissertation examines four issues related to changes in the American healthcare industry during the early 1900's.Chapter 2 examines changes in medical education. This chapter provides a qualitative analysis of motivations behind the medical education reforms in America and an empirical analysis of the shakeout of medical schools that occurred from 1905 to 1920. Licensing laws and medical school reviews were found to have influenced exiting decisions of many medical schools. Reform of medical education in America was followed by a disproportionate decline of physician supply in rural areas. Along these lines, Chapter 3 provides a case study of the geographic distribution of physicians during the early 20th Century. Data on individual physicians was compiled to analyze variation in physician counts across counties and to investigate out-migration of rural county physicians. This analysis indicates physicians were drawn more and more to areas offering better financial opportunities, greater access to medical facilities, and more opportunity for professional contact.It is unclear to what extent patients initially benefited from the changes in medicine. Chapters 4 and 5 focus on one aspect of this issue by examining the impact of physicians on mortality rates. Chapter 4 utilizes the individual physician data from Chapter 3 to assess whether variation in physician counts explain variation in infant and non-infant mortality rates across counties. Estimates indicate that physicians were still unable to reduce mortality in the early 1920's. Chapter 5 focuses on the impact on maternal mortality resulting from the transition of childbirth during the first half of the 20th Century from the home to the hospital setting. Using hospital beds as a proxy for medical inputs, regression analysis revealed that the transition may have contributed to more maternal deaths until the introduction of sulfa drugs in the late 1930's.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectHealthcareen_US
dc.subjectFlexneren_US
dc.subjectMedical Educationen_US
dc.subjectPhysician Locationen_US
dc.subjectPhysician Impacten_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineEconomicsen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorFishback, Price V.en_US
dc.contributor.chairFishback, Price V.en_US
dc.contributor.committeememberOaxaca, Ronald L.en_US
dc.contributor.committeememberLibecap, Garyen_US
dc.contributor.committeememberFlores-Lagunes, Alfonsoen_US
dc.identifier.proquest1281en_US
dc.identifier.oclc137354789en_US
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