Flexner Report
Abraham Flexner was assigned to direct John D. Rockefellers restructering of American medical school. Never mind that Abraham himself knew nothing about medicine—after all, physicians were the problem, right? To bone up, he spent two years evaluating the organizational structure of several European medical schools, including those in England, France, and Germany. In 1910, he published his Flexner Report, which decried the state of American medical education for lack of evidence-based medicine (the same cry we hear today, by the way), and advocated for far-reaching reform in the training of doctors.
Abraham doubted the scientific validity of all forms of medicine other than those based on research; everything else was quackery and charlatanism. To be fair, much of it was. Medical schools had to drop electromagnetic field therapy, phototherapy, physiomedicalism, naturopathy, homeopathy, and several other questionable practices. And, most important, nutrition was drop as well. Neither Flexner brother ever embraced the concept of diet or nutrition as part of the new medical curriculum because there was no money to be made in it.
Eighty percent of medical colleges nationally were forced to shutter for either not meeting standards or not overhauling their curricula. The osteopathic and chiropractic schools were directly in the crosshairs, and while they protested, there wasn’t much that could be done. The fix was in. Although almost all the alternative medical schools listed in Flexner’s report were closed, the International Association of Chiropractic Schools and Colleges (IACSC) was formed, with nineteen member colleges. The American Osteopathic Association (AOA) also brought a number of osteopathic medical schools into compliance with Flexner’s recommendations to produce an evidence-based practice. The curricula of DO- and MD-granting medical schools are now nearly identical, except that osteopathic schools still teach osteopathic manipulative medicine (OMM).
Rockefeller, Pritchett, and the AMA presented the Flexner Report to Congress in 1911, which adopted it without change. Since then, it’s never been updated. The report aligned well with Flexner’s strategy, the AMA’s strategy, Johns Hopkins’s striving for preeminence among major American medical schools, and the quest for new drugs that could advance the nascent pharmaceutical industry’s (and Rockefeller’s) objectives.
References
- Lustig, Robert. (2021). Metabolical Chapter 6. Because Big Pharma Was Their Teacher (p. 115). New York, NY: HarperCollins Publishers.