Professionalization

“. . . attempting to gauge with exactitude the extent to which nineteenth-century physicians were, by present standards, scientific, proves an unproductive task. Patients judged the profession by the criteria of their age, an authority which was incapable of distinguishing in any absolute sense the relative scientific merit of, for example, a phrenologist or his opponent. Given this limitation, ‘valid’ science becomes irrelevant to the attainment of status, while to pursue diligently its antecedents adds little to an understanding of the past. What is of paramount importance, however, is the manner in which physicians used, not the content, but the rhetoric of science. In an analysis of the deployment of science of physicians it will become apparent that the nineteenth-century profession, though outwardly demonstrating increasing homogeneity, must be resolved into a series of distinct and frequently competing subgroups. Each of these fragments invoked a definition of biomedical knowledge designed to accord with its particular aspirations. In effect, science, mirroring the profession itself, must be seen not as a fixed entity but as a collage of discrete and malleable constituents. (Shortt, 60) . . . The terminology of science, then, had entered the substratum of nineteenth-century British thought at a level quite divorced from its practical achievements. This subtle invasion made a significant contribution to medical professionalization: physicians portrayed themselves as exemplars of science to a public receptive to the idiom in which these claims were phrased. Under the guise of an objective explanation of natural phenomena, science became a code-word for a methodology, a designation for specialized expertise, and a vehicle for social mobility. . . . [sufficient evidence suggests that] American physicians were not unlike their British counterparts: specific subgroups within the profession fashioned their own definitions of science in their search for acceptable socioeconomic stature” (63-64).