Abraham Flexner A C A D E M I C M E D I C I N E ’ S FA V O R I T E S C A P E G O AT
Written by Linda Rosa, RN
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t’s not surprising that quack practitioners having long blamed Abraham Flexner for closing “alternative medicine” schools in the early 20th century because of “prejudice” against non-science-based health care. But it came as something of a shock to hear that no less than the Association of American Medical Colleges (AAMC) recently scrubbed his name from their most prestigious award for “Distinguished Service to Medical Education” for having “racist and sexist views.” (Redford) While not denying Flexner’s positive impact on modern medical eduction, this demotion was done in service to AAMC’s commitment to “becoming anti-racist, diverse, equitable, and inclusive.” AAMC also sees Flexner’s celebrated 1910 Report (“Medical Education in the United States and Canada”), based on first-hand inspections of all 155 US and Canadian medical schools, as “contributing” to the closure of five of seven Black medical schools existing at that time. Because AAMC gives scant evidence for its accusations, skepticism is warranted. RACIST? AAMC gives two examples for Flexner’s allegedly “racist” and “pejo2 8 | 2022 VO LUME 13
rative language” in his Report. First, it charges: “…Flexner asserted that African American/Black individuals were better suited to serve as sanitarians rather than surgeons…” [emphasis added] But Flexner’s actually statement in context was: “A well-taught negro sanitarian will be immensely useful; an essentially untrained negro wearing an M.D. degree is dangerous… The negro needs good schools rather than many schools — schools to which the more promising of the race can be sent to receive a substantial education in which hygiene rather than surgery, for example, is strongly accentuated.” [emphasis added; Report, p.180] What AAMC failed to acknowledge was that ‘sanitarians’ in the 19th and early 20th Centuries were medical doctors and researchers specializing in public health (Freedman), not ‘sanitation workers’ or ‘health inspectors’ – not what The Washington Post (and others) would interpret as a “menial role” when editorializing on the defenestration of Flexner. (Cohen, 2021) At the time of Flexner’s Report, sanitarian physicians were afforded considerable status for researching and combatting the spread of dread diseases, such as
cholera, typhoid, smallpox, and tuberculosis which were leading causes of death. Because of poor nutrition and hardships, Blacks were dying at a higher rate. Moreover, specializing in public health didn’t exempt Black schools from the high standards expected of all medical schools. Note AAMC’s straw man: Flexner’s Report nowhere claims Blacks to be “better suited” as sanitarians, but rather as such would be “immensely useful.” Flexner actually was restating the primary mission of the two surviving Black medical schools that he worked to save – Meharry (Tennessee) and Howard (Washington, DC). Both schools had emphasized public health as offering the greatest need of Black communities. As for writing, “an essentially untrained negro wearing an M.D. degree is dangerous,” Flexner was not saying anything about Blacks having inferior intellectual abilities. He believed public had much to fear from all untrained physicians: “…a nostrum containing dangerous drugs is doubly dangerous if introduced into the household by the prescription of a physician who knows nothing of its composition and is misled as to its effect.” (Report, p. 65) Flexner regarded osteopaths so
