October 17, 2012, 12:00 PM to 1:30 PM
Room 2019, Floor 2U, Claire Fagin Hall
Abstract: Through colonial times and through the nineteenth century, Philadelphia rightly claimed status as the pre-eminent city for medicine and medical education. Here arose the first anatomical teaching, the first medical school, the first general hospital, possibly the first structured nursing training—and one could go on. The strength derived from the city’s upper strata of broadly knowledgeable physicians and surgeons, many of them of the gentlemanly cast, and not a few adept in other areas of intellectual or artistic pursuit. The foundational science for most of these practitioners was pathology, stemming in part from the old days in Paris. A sizeable cluster of women physicians and surgeons added an unusual element to Philadelphia’s medical personality. Many of the elite doctors were teachers: and indeed, it was medical education for which the city was best known. Seemingly, a medical school sprouted for every conceivable taste and need, while Pennsylvania Hospital and PGH—and numerous other hospitals—offered some of the most sought after post-graduate posts. Enough diseases and injuries occurred in the increasingly crowded and industrial nineteenth-century metropolis to make a sufficient number of Philadelphians "clinical material," not to mention the need to supply the "anatomical tables." Dominance in medical publishing helped spread the fame of Philadelphia as the medical city of the nation.
But much was to change beginning in the late 1880s and 1890s, as experimental laboratory research grew into an imperative for perceived medical excellence. The University of Pennsylvania School of Medicine stood as the obvious, and in fact only, potential champion to lead the medical city in the new direction—but old ways had succeeded too long there and elsewhere, and a critical reform movement failed, with woeful consequences. At a time when expansion in the direction of research demanded new sources of funding, Philadelphia’s peculiar ways of philanthropy could not help. The action shifted to Baltimore, New York, and Boston. Equilibration eventually occurred, as each medical school founds pathways to research productivity. After World War II, enhanced funding opportunities (NIH, Medicare) helped level the playing fields. By the later twentieth-century, data and new MD’s flowed from everywhere, and no one had to travel very far from open-heart surgery or an MRI. No one locus in the United States could anymore claim to be the nation’s "city of medicine"--except Durham, North Carolina, but a branding tag does not convince.
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