The early 20th century saw a significant transformation in the quality of medical education in the United States. This period witnessed a drastic reduction in the number of medical schools and medical school graduates, which had far-reaching implications for healthcare and mortality rates. A recent study conducted by researchers from Carnegie Mellon University, Stanford University, and Marquette University delved into the aftermath of these medical school closures between 1900 and 1930.
The closure of numerous medical schools during this era led to a 4% decrease in physicians per capita, resulting in declines in infant mortality, non-infant mortality, and total mortality. The study, published as an NBER Working Paper, sheds light on the impact of the Flexner-era medical school closures on healthcare outcomes and mortality rates.
The Flexner Report, published in 1910, called for the closure of a large number of substandard medical schools in the United States. This led to the shutdown of over 40% of medical schools between 1905 and 1915. The study aimed to investigate the effects of these closures on mortality rates by analyzing data from the U.S. Census and county-level vital statistics from 1900 to 1930.
Key findings from the study include:
– Counties located within 300 miles of closed medical schools experienced the most significant impact, with a 4% decrease in physicians per capita.
– Market adjustments to these closures saw physicians migrating to counties with higher school closure intensity values, offsetting the decrease in new medical graduates.
– Nurse per capita increased in counties near closures, while midwives per capita remained unchanged.
– Infant, non-infant, and total mortality rates decreased in counties with average closure intensity values, with an estimated 16,000 infant lives and 38,000 non-infant lives saved annually.
The study suggests that the reduction in poorly trained physicians following medical school closures contributed to the decline in mortality rates, particularly in causes sensitive to physician quality. Factors such as the presence of a county public health department, hospital availability, and public health spending were found to be either unrelated or negatively related to medical school closures.
Overall, the research highlights the long-term impact of early 20th-century medical school closures on healthcare outcomes and mortality rates. By reducing the supply of inadequately trained physicians, these closures ultimately led to improvements in public health and saved thousands of lives annually. The study provides valuable insights into the historical evolution of medical education in the United States and its implications for healthcare delivery and mortality.
