Discrimination in Health Care

The history of hospital care has provided special and sometimes dramatic views of developments in medical technology and medical care. Hospital settings have mirrored educational, research, and ethical issues; the roles of health professionals; ways in which care is delivered; and concerns about medical policy.

Until the late 19th century, almost all patients received their medical care at home. Therapy was comparatively simple, and surgery was rudimentary. The introduction of asepsis from 1867 to 1870 and the adoption of anesthesia between 1846 and 1880 advanced the development of abdominal surgery and helped move surgery from kitchen tables to hospitals. Experiences with mass casualties during the Civil War and the advent of professional nursing made hospitals safer and more effective. Physicians, with expanded skills and capabilities and the need to use their time more efficiently, increasingly insisted on the use of hospitals. The number of acute-care hospitals in the United States grew from fewer than 200 in 1873 to greater than 4000 in 1910 and 6000 in 1920. By 1937, more than 80% of the nation's physicians had hospital privileges [1]. Hospitals had become established and essential for proper care. Unfortunately, they also exposed stark examples of medical injustice.

In many areas of the country, African-American patients were barred from appropriate hospital care. They were either denied admission to hospitals or, if admitted, were often segregated in special areas and usually received poor care and services. African-American physicians were refused appointments to hospital staffs and could not treat their hospitalized …