Date of Award

1-1-2023

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Naomi Rogers

Abstract

Pediatrics as a medical specialty underwent a profound transformation between 1908 and the early 1920s. During these last years of the Progressive Era, countless government and private organizations were heavily involved in the movement to advance the welfare of children. This paper will attempt to examine how elite academic pediatricians viewed their work and their nascent medical specialty against the backdrop of this wider social and legal reform movement. At first, many of these elite pediatricians supported the child welfare movement individually, but the years prior to the commencement of World War I in 1914 were marked by debate over whether—and to what degree—pediatricians should embrace the more “sociological” work of the broader movement or limit themselves to more strictly scientific “medical” work. This discussion—along with calls for greater pediatric leadership of the child welfare movement and increased efforts by pediatricians to engage with sociomedical issues— intensified in the years leading up to American involvement in World War I in 1917. There was a nascent, if ineffectual, movement within elite academic pediatric societies to engage more with sociomedical issues. Pediatricians’ failure to voice a meaningful collective response to attempts to regulate child labor through federal legislation in 1916 was emblematic of the disjointed, individualistic, and largely scientific orientation of elite pediatricians during this time. The war experience of elite American pediatricians was a turning point: wartime leadership experiences overseas and an increasingly hierarchical organization of society by the federal government provided the material for elite pediatricians to assert greater leadership over the broader child welfare movement. Pediatricians took advantage of these gains in the post-war environment, as demonstrated by efforts of elite pediatric organizations to lead reorganization of the sprawling child-welfare movement and to incorporate preventive medicine into the core of pediatricians’ work. Pediatricians' increased distinctiveness—and unique social identity of “pediatrics” and “pediatricians” compared to fifteen years prior—was further demonstrated in arguments about the need to teach other medical professionals and students of the specialized preventive medicine vantage point of the pediatrician. It was also seen in the split between pediatricians and the American Medical Association over the 1921 Sheppard-Towner Act, which provided federal support for maternal and infant welfare. In just fifteen years, elite pediatricians had helped to incorporate sociological approaches and the broader child welfare movement into their medical specialty, which was increasingly separating itself from other areas of medical practice. Significant legal developments during this era raised many of the same issues, like the appropriate breadth of federal power, that would alter—and be altered by—the development of pediatricians’ social identity.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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