Journal of Health Politics, Policy and Law
Guest Editorid
The New York Academy of Medicine Marvin Lieberman, Committee on Medicine in Society, the New York Academy of Medicine
The New York Academy of Medicine was formally organized in 1847 by leaders of the medical profession in New York City who not only were greatly concerned with the rise of homeopathic medicine but who also sought to diminish the numerous factional controversies characteristic of medicine in the mid-19th century. At the founding meeting of the Academy on December 12, 1846, much was said about “the rampancy of quackery,” “science and roguery,” and the need to exclude from the profession both practitioners of homeopathic medicine and those “who met and consulted with them.” “Regular practitioners,” frustrated by the provisions of the county medical society’s act of incorporation which opened its membership to homeopaths and other “irregular practitioners” or sectarians,2 began a new organization. In the 1840s growing cleavages emerged in the medical profession over therapy, etiology, and the organization of the profession. Thus, it has been suggested that the intensity with which the regulars reacted against homeopathy was due to a fear, “not just that persons already secessionist would grow in public favor, but also that respectable physicians might decide intellectual issues on an irrational basis that would allow confusion or social and economic motives to become the deciding forces in the intellectual sphere. ’73 The original by-laws of the Academy, prepared in 1847, stated the following goals: First: the separation of the regular from irregular practitioners. Second: the association of the profession proper for purposes of mutual recognition and fellowship. Third: the promotion of the character, interests, and honor of the fraternity by maintaining the union and harmony of the regular profession in the city and its vicinity, and aiming to elevate the standard of medical education. Fourth: the cultivation and advancement of the sciences by our united exertions for mutual improvement, and our contributions to medical literature. 150
Published by Duke University Press
Journal of Health Politics, Policy and Law
Lieberman Guest Editorial
151
The 1956 constitution of the Academy has a more succinct statement of goals: The advancement of the science and art of medicine, the maintenance of a public medical library, and the promotion of public health and medical education. From its inception, the Fellowship of the Academy has comprised many of the most prestigious and influential members of the medical profession in New York City, including medical practitioners, scholars, and administrators. At present, the Academy membership stands at approximately 2,500, most of whom are resident Fellows. The Academy Fellowship also includes some 300 Associate Fellows, nonphysicians who teach or work in fields allied to medicine. New Fellows are selected upon the recommendation of three current Fellows after review by an admissions committee and approval by the Council of the Academy. The Council, which determines the policy of the Academy and supervises its activities, includes the president of the Academy, who serves for a two-year term, three vice presidents, a recording secretary, treasurer, and the chairmen of the standing committees: Admissions, Library, Medical Education, Public Health, and Medicine in Society. The permanent staff of the Academy is headed by a director who is assisted by the chief librarian, the executive secretaries of the standing committees, and the editor of the Bulletin. The Academy library has been described as its “greatest material heritage,” and is not only of scientific importance but has special relevance to students of health politics, policy and law. In addition, it contains more than one million bound and unbound volumes and thousands of periodicals; its rare and historical materials are unsurpassed in the country. Since the New York h b l i c Library does not contain medical books or journals, the Academy library is the only medical reference source open to the public in the metropolitan area. With the accession of the Michael M. Davis Collection, which contains articles, memoranda, correspondence and clippings compiled by Dr. Davis over 50 years, the Academy has added to a collection noteworthy for material on 19th-century American medical history an indispensable research source in the politics and history of medical care in the first half of the 20th century. The Bulletin of the New York Academy of Medicine, a monthly journal, not only contains scientific articles but also features proceedings of conferences held at the Academy which cover a wide range of topics including the social and historic areas of medicine. The Academy of Medicine influences the health affairs of the community through the work of its three major standing committees: the
Published by Duke University Press
Journal of Health Politics, Policy and Law
152
Journal of Health Politics, Policy and Law
Committee on Public Health founded in 1911, the Committee on Medical Education and its affiliated sections organized around various medical specialties founded in 1912, and the Committee on Medicine in Society formed in 1939. The Committee on Public Health, in effect the oldest of the standing committees of the Academy, functions in three ways: first, “in an advisory capacity to community representatives when guidance on a medical or public health issue is called for”; second, through “undertaking of surveys and inquiries into existing conditions”; and, finally, as an educational body which conducts conferences and issues papers for the medical profession and the community at large. Dr. James Alexander Miller, a physician who served on the Committee for more than 30 years, was not exaggerating when he said that “largely through this Committee, the Academy has developed from a medical society to a powerful civic in~titution.”~ The Committee’s reports and recommendations have contributed to the reform of the New York City Board of Health, the shift from a coroner system to a chief medical examiner, and to the reform of blood banking in New York. It led the opposition to the current approach to the control of heroin addiction and marijuana. It played an important part in legitimizing the birth-control movement. Its most important contribution, perhaps, was in improving the welfare of mothers and children through periodic studies and recommendations concerning neonatal deaths and prenatal care including, among others, “Znfunt and Maternal Cure in New York City, published by Columbia University Press in 1952. Active in the role of the Committee were international leaders such as Hermann M. Biggs, S.S. Goldwater, and Haven Emerson. A large measure of its success was due to Dr. E. H. L. Corwin, who served as its executive secretary for 40 years, from 1911 through 1952. The Committee on Medical Education had its inception in 1912 with the organization of a Society for Advancement of Clinical Study, whose purpose was to publicize clinics and medical meetings. This society merged with a group concerned with postgraduate medical study in 1924 to form the Academy’s Committee on Medical Education. This group organizes programs, lectures, conferences on postgraduate medical education. coordinates the various programs of the specialty sections; and studies special problems related to medical education. The sections of the Academy, now numbering seventeen and ranging from historical medicine to biomedical engineering, through frequent meetings provide a major part of the Academy’s activities in continuing medical education. In recent years the committee has conducted annual symposia on matters dealing with important public policy issues such as the organization of medical school curricula, health-manpower legislation, and family practice. These proceedings have been published in the Bulletin. ”
Published by Duke University Press
Journal of Health Politics, Policy and Law
Lieberman Guest Editorial
153
The Committee on Medicine in Society, founded in 1939, concerns itself with the social aspects of medicine by way of conferences, seminars, and other media. Its first executive secretary, Iago Galdston, M.D., was largely responsible for its multi-disciplinary orientation. A major activity of the Committee is the annual spring health conference which dates back to the mid-forties. These meetings are devoted to social and political issues in health care. Proceedings appear in the Academy Bulletin. Recent meetings were: The Hospital Reconsidered: A New Perspective, 1978; Health Policy: Reasonable Priorities and Realistic Expectations, 1977; Issues in Primary Care, 1976; The Professional Responsibility for Quality of Care, 1975; Prevention and Health Maintenance Revisited, 1974. The Committee has also conducted a series of closed seminars which have included Medicine and the Changing Social Order in the forties; Whither Medicine in the fifties, and Social Policy for Health Care in the sixties. The last series of seminars formulated a policy statement adopted by the Academy in 1965 which stated that health care is a right of all persons. This statement contributed to the policy consensus which led to the passage of the Medicare Law. A recent closed seminar was conducted by the Committee under contract with the National Institute of Occupational Safety and Health, Department of Health, Education, and Welfare, in 1977, on Ethical Issues in Occupational Health. The proceedings of this meeting will be published in the Bulletin in September 1978. Through its subcommittees, the Committee also maintains interests in long-term care, medical ethics, occupational safety and health, and resident and attending physician conflicts. It has recently developed a collaborative effort with other public and voluntary health agencies in New York to promote health education of the public. The New York Academy of Medicine is a venerable medical organization with a distinguished history of contributors to the profession of medicine as well as to the public weal. In the more than 130 years of its existence it has seen extraordinary changes in health care: the rise of the hospital and medical school to dominance in medical care and medical education; a shift in power in health affairs from local governments to the state and federal level; and changes in the role of urban centers such as the City of New York in our society. The impact of these changes on the Academy of Medicine has been significant and will require it to continue to adapt to its environment. Medical schools and hospitals ziienew a primary source of graduate and postgraduate medical education with a new emphasis on continuing medical educatiofl. The Academy continues to play an important role in this area, not only for the medical profession but also for allied health personnel and for health education for the public. As the impact of government-financed medical education increases, the Academy’s voice
Published by Duke University Press
Journal of Health Politics, Policy and Law
154
Journal of Health Politics, Policy and Law
on policy issues will continue to be effective. With the shift in responsibility in health affairs from the local to the state governments, the Academy is developing newer and closer relationships with the State Health Department, especially in matters of quality of care and physicians’ discipline, while continuing its involvement in national problems of health care. As concern about environmental risks to health and occupational health problems increases, the Academy through its standing committees is in the forefront, seeking to develop rational approaches to these concerns. In the face of the troublesome and complex health issues which continue to confront society, a Fellowship representing the broadest spectrum of expertise and opinion continues to be an indispensable source for clarifying and resolving health problems. Notes 1 . Philip Van Ingen, The New York Academy of Medicine, Its First Hundred Years (New York: Columbia University Press, 1949), p. 6. 2 . William G. Rothstein, American Physicians in the Nineteenth Century, From Sects to Science (Baltimore: The Johns Hopkins University Press, 1972), p. 169. 3 . Daniel H. Calhoun, Professional Lives in America, Structure and Aspiration, 1750-1850 (Cambridge, Mass.: Harvard University Press, 1%5), pp. 46-47. 4. Van Ingen, pp. 7-8. 5 . E. H. L. Corwin and E. V. Cunningham, Thirty Years in Community Service, 1911-1941 (New York: New York Academy of Medicine, IN]), p. 6. 6 . Ibid., p. 4.
Published by Duke University Press
Guest Editorid
The New York Academy of Medicine Marvin Lieberman, Committee on Medicine in Society, the New York Academy of Medicine
The New York Academy of Medicine was formally organized in 1847 by leaders of the medical profession in New York City who not only were greatly concerned with the rise of homeopathic medicine but who also sought to diminish the numerous factional controversies characteristic of medicine in the mid-19th century. At the founding meeting of the Academy on December 12, 1846, much was said about “the rampancy of quackery,” “science and roguery,” and the need to exclude from the profession both practitioners of homeopathic medicine and those “who met and consulted with them.” “Regular practitioners,” frustrated by the provisions of the county medical society’s act of incorporation which opened its membership to homeopaths and other “irregular practitioners” or sectarians,2 began a new organization. In the 1840s growing cleavages emerged in the medical profession over therapy, etiology, and the organization of the profession. Thus, it has been suggested that the intensity with which the regulars reacted against homeopathy was due to a fear, “not just that persons already secessionist would grow in public favor, but also that respectable physicians might decide intellectual issues on an irrational basis that would allow confusion or social and economic motives to become the deciding forces in the intellectual sphere. ’73 The original by-laws of the Academy, prepared in 1847, stated the following goals: First: the separation of the regular from irregular practitioners. Second: the association of the profession proper for purposes of mutual recognition and fellowship. Third: the promotion of the character, interests, and honor of the fraternity by maintaining the union and harmony of the regular profession in the city and its vicinity, and aiming to elevate the standard of medical education. Fourth: the cultivation and advancement of the sciences by our united exertions for mutual improvement, and our contributions to medical literature. 150
Published by Duke University Press
Journal of Health Politics, Policy and Law
Lieberman Guest Editorial
151
The 1956 constitution of the Academy has a more succinct statement of goals: The advancement of the science and art of medicine, the maintenance of a public medical library, and the promotion of public health and medical education. From its inception, the Fellowship of the Academy has comprised many of the most prestigious and influential members of the medical profession in New York City, including medical practitioners, scholars, and administrators. At present, the Academy membership stands at approximately 2,500, most of whom are resident Fellows. The Academy Fellowship also includes some 300 Associate Fellows, nonphysicians who teach or work in fields allied to medicine. New Fellows are selected upon the recommendation of three current Fellows after review by an admissions committee and approval by the Council of the Academy. The Council, which determines the policy of the Academy and supervises its activities, includes the president of the Academy, who serves for a two-year term, three vice presidents, a recording secretary, treasurer, and the chairmen of the standing committees: Admissions, Library, Medical Education, Public Health, and Medicine in Society. The permanent staff of the Academy is headed by a director who is assisted by the chief librarian, the executive secretaries of the standing committees, and the editor of the Bulletin. The Academy library has been described as its “greatest material heritage,” and is not only of scientific importance but has special relevance to students of health politics, policy and law. In addition, it contains more than one million bound and unbound volumes and thousands of periodicals; its rare and historical materials are unsurpassed in the country. Since the New York h b l i c Library does not contain medical books or journals, the Academy library is the only medical reference source open to the public in the metropolitan area. With the accession of the Michael M. Davis Collection, which contains articles, memoranda, correspondence and clippings compiled by Dr. Davis over 50 years, the Academy has added to a collection noteworthy for material on 19th-century American medical history an indispensable research source in the politics and history of medical care in the first half of the 20th century. The Bulletin of the New York Academy of Medicine, a monthly journal, not only contains scientific articles but also features proceedings of conferences held at the Academy which cover a wide range of topics including the social and historic areas of medicine. The Academy of Medicine influences the health affairs of the community through the work of its three major standing committees: the
Published by Duke University Press
Journal of Health Politics, Policy and Law
152
Journal of Health Politics, Policy and Law
Committee on Public Health founded in 1911, the Committee on Medical Education and its affiliated sections organized around various medical specialties founded in 1912, and the Committee on Medicine in Society formed in 1939. The Committee on Public Health, in effect the oldest of the standing committees of the Academy, functions in three ways: first, “in an advisory capacity to community representatives when guidance on a medical or public health issue is called for”; second, through “undertaking of surveys and inquiries into existing conditions”; and, finally, as an educational body which conducts conferences and issues papers for the medical profession and the community at large. Dr. James Alexander Miller, a physician who served on the Committee for more than 30 years, was not exaggerating when he said that “largely through this Committee, the Academy has developed from a medical society to a powerful civic in~titution.”~ The Committee’s reports and recommendations have contributed to the reform of the New York City Board of Health, the shift from a coroner system to a chief medical examiner, and to the reform of blood banking in New York. It led the opposition to the current approach to the control of heroin addiction and marijuana. It played an important part in legitimizing the birth-control movement. Its most important contribution, perhaps, was in improving the welfare of mothers and children through periodic studies and recommendations concerning neonatal deaths and prenatal care including, among others, “Znfunt and Maternal Cure in New York City, published by Columbia University Press in 1952. Active in the role of the Committee were international leaders such as Hermann M. Biggs, S.S. Goldwater, and Haven Emerson. A large measure of its success was due to Dr. E. H. L. Corwin, who served as its executive secretary for 40 years, from 1911 through 1952. The Committee on Medical Education had its inception in 1912 with the organization of a Society for Advancement of Clinical Study, whose purpose was to publicize clinics and medical meetings. This society merged with a group concerned with postgraduate medical study in 1924 to form the Academy’s Committee on Medical Education. This group organizes programs, lectures, conferences on postgraduate medical education. coordinates the various programs of the specialty sections; and studies special problems related to medical education. The sections of the Academy, now numbering seventeen and ranging from historical medicine to biomedical engineering, through frequent meetings provide a major part of the Academy’s activities in continuing medical education. In recent years the committee has conducted annual symposia on matters dealing with important public policy issues such as the organization of medical school curricula, health-manpower legislation, and family practice. These proceedings have been published in the Bulletin. ”
Published by Duke University Press
Journal of Health Politics, Policy and Law
Lieberman Guest Editorial
153
The Committee on Medicine in Society, founded in 1939, concerns itself with the social aspects of medicine by way of conferences, seminars, and other media. Its first executive secretary, Iago Galdston, M.D., was largely responsible for its multi-disciplinary orientation. A major activity of the Committee is the annual spring health conference which dates back to the mid-forties. These meetings are devoted to social and political issues in health care. Proceedings appear in the Academy Bulletin. Recent meetings were: The Hospital Reconsidered: A New Perspective, 1978; Health Policy: Reasonable Priorities and Realistic Expectations, 1977; Issues in Primary Care, 1976; The Professional Responsibility for Quality of Care, 1975; Prevention and Health Maintenance Revisited, 1974. The Committee has also conducted a series of closed seminars which have included Medicine and the Changing Social Order in the forties; Whither Medicine in the fifties, and Social Policy for Health Care in the sixties. The last series of seminars formulated a policy statement adopted by the Academy in 1965 which stated that health care is a right of all persons. This statement contributed to the policy consensus which led to the passage of the Medicare Law. A recent closed seminar was conducted by the Committee under contract with the National Institute of Occupational Safety and Health, Department of Health, Education, and Welfare, in 1977, on Ethical Issues in Occupational Health. The proceedings of this meeting will be published in the Bulletin in September 1978. Through its subcommittees, the Committee also maintains interests in long-term care, medical ethics, occupational safety and health, and resident and attending physician conflicts. It has recently developed a collaborative effort with other public and voluntary health agencies in New York to promote health education of the public. The New York Academy of Medicine is a venerable medical organization with a distinguished history of contributors to the profession of medicine as well as to the public weal. In the more than 130 years of its existence it has seen extraordinary changes in health care: the rise of the hospital and medical school to dominance in medical care and medical education; a shift in power in health affairs from local governments to the state and federal level; and changes in the role of urban centers such as the City of New York in our society. The impact of these changes on the Academy of Medicine has been significant and will require it to continue to adapt to its environment. Medical schools and hospitals ziienew a primary source of graduate and postgraduate medical education with a new emphasis on continuing medical educatiofl. The Academy continues to play an important role in this area, not only for the medical profession but also for allied health personnel and for health education for the public. As the impact of government-financed medical education increases, the Academy’s voice
Published by Duke University Press
Journal of Health Politics, Policy and Law
154
Journal of Health Politics, Policy and Law
on policy issues will continue to be effective. With the shift in responsibility in health affairs from the local to the state governments, the Academy is developing newer and closer relationships with the State Health Department, especially in matters of quality of care and physicians’ discipline, while continuing its involvement in national problems of health care. As concern about environmental risks to health and occupational health problems increases, the Academy through its standing committees is in the forefront, seeking to develop rational approaches to these concerns. In the face of the troublesome and complex health issues which continue to confront society, a Fellowship representing the broadest spectrum of expertise and opinion continues to be an indispensable source for clarifying and resolving health problems. Notes 1 . Philip Van Ingen, The New York Academy of Medicine, Its First Hundred Years (New York: Columbia University Press, 1949), p. 6. 2 . William G. Rothstein, American Physicians in the Nineteenth Century, From Sects to Science (Baltimore: The Johns Hopkins University Press, 1972), p. 169. 3 . Daniel H. Calhoun, Professional Lives in America, Structure and Aspiration, 1750-1850 (Cambridge, Mass.: Harvard University Press, 1%5), pp. 46-47. 4. Van Ingen, pp. 7-8. 5 . E. H. L. Corwin and E. V. Cunningham, Thirty Years in Community Service, 1911-1941 (New York: New York Academy of Medicine, IN]), p. 6. 6 . Ibid., p. 4.
Published by Duke University Press
