Medical Licensure 5000 to 165 Years Ago
Written by Chris Dalrymple, DC   
Monday, August 10, 2015 12:00 AM

circa 3000 B.C.E. to circa 30 B.C.E.:  Egyptian Civilization

Documents from the Egyptian Civilization demonstrates that workers were offered a variety of healthcare benefits, including paid sick days and free visits to physicians.  The records prove that the workers visited three types of medical providers:  the physician, the scorpion charmer and the wise woman. Read More

circa. 1754 B.C.E.:  Code of Hammurabi establishes patient fees and punishment for negligent treatment in Babylonia.

circa 1200 B.C.E. to circa 500 C.E.:  Ancient Greek Civilization 

circa 750 B.C.E. to circa 476 C.E.: Roman Civilization 

The Greeks and Romans  practiced “a distinction based on education determined who served the masses and who served the elite.  Temple priests who were formally educated served the aristocracy, while common practitioners with less formal medical education served the needs of community members who could afford to pay fees for service.  Finally, the indigent were served by folk practitioners, primarily women, who cultivated their healing herbs and learned from each other the secrets of healing. In fact women were barred for centuries from reading books and attending lectures, thus prohibiting them from entering the recognized practice of medicine." 

circa 1300s:  In Europe, the elite continued to be served by physicians trained and licensed by university-related medical schools.  Demand for medical services among the masses “assured that women (sometimes known as ‘witches’ and other self-trained practitioners continued to provide aid to the public.  In response, merchant guilds began to form in Europe to fill the need for trained practitioners who could meet the masses’ needs.  The guilds provided medical training to members who were then given the right to practice medicine upon completion of the training."

circa 1422:  English Parliament outlaws apprenticeship programs and required university graduation of all practitioners.

circa 1500: Parliament creates the College of Physicians and Surgeons charged with making medical licensing decisions.

circa 1600 - 1700s: Colonial America makes us of apprenticeship tradition of training.  "Early licensing laws adopted in the colonies reflected a general lack of concern about regulating who practiced medicine."

1639:  Virginia enacts the first physician licensing statute.  It merely controlled the fees charged by medical practitioners.  The various colonial practice acts included “no practice restrictions and instead focused on prohibitions against excessive fees.  Thus, for the next 100 years, anyone who set up a medical practice and inspired confidence was welcomed as a community [medical] practitioner."

circa mid 1700s:  Medical schools and medical societies proliferate.  One of the first medical schools was begun in Philadelphia in 1765 and hoped to issue medical licenses.  This authority was refused by the British Government.

circa late 1700s:  Medical societies were more successful in advocating for regulation of the profession, and the colonies began to include practice restrictions in their medical practice acts.

1772:  New Jersey passed the “first comprehensive medical practice act, which included a licensing requirement and created a board to regulate the practice of medicine.  This regulatory board was given the authority both to examine a physician before granting a license and to levy fines against those who were practicing without a license.”  Other states followed New Jersey’s lead, but relied upon medical societies to regulate the profession.

1800:  Thirteen of the 16 existing states had given their state medical societies the authority to both examine and license university-trained and apprentice-trained practitioners.

1803:  Massachusetts allows Harvard Medical School to license its graduates and other states also began to permit their medical schools to license their graduates creating an "alternative pathway to a medical license encouraging a rapid proliferation of medical schools in the early 1800s.  "Those who entered the medical schools were not required to have a high school education, and some of the medical schools provided no more than a few months of training before licensing their graduates.  Furthermore, most [medical] schools provided no clinical training."

First half of 1800s:  “The practice of medicine was deregulated during the first half of the 1800s.”  “This period saw the growth of new schools of thought about how to practice medicine.  Lay healers, bone setters, botanic Thompsonians, homeopaths, eclectics, and others began to offer medical services, and these ‘new schools’ of medicine rapidly produced practitioners for the masses.  States began to repeal licensing laws, and by 1849, only New Jersey and the District of Columbia had laws that set out anything close to a regulatory scheme."

Note:  B.C.E. and C.E. are the “modern scientific nomenclature” to represent B.C. and A.D.  They represent “Before Common Era” and “Common Era."