He Who Pays the Piper: Foundations, the Medical Profession, and Medical Education Reform

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Abstract
The development of modern medical education was shaped by the medical profession's own reform strategies and by material and ideological support from the corporate class. This article examines how the Rockefeller medical philanthropies, the largest single source of funds for medical education reform from 1910 through the 1930s, forced the adoption of a specific reform—full-time clinical faculty—to make medicine serve the needs of capitalist society rather than the interests of the medical profession. Memorandums and letters from archival files demonstrate that foundation leaders believed the full-time plan would separate medical schools from the grip of practitioner-dominated medical societies, bringing all medical faculty under the control of foundations and university boards of trustees. This policy was to be a first step in rationalizing medical care and distributing the technical benefits and social-control functions of medicine to all segments of the population. The author traces the development of the full-time plan, its adoption as foundation policy, and the struggle over its implementation.

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