Alexus Williams is a junior at Grinnell College majoring in English. She enjoys dance, film and fiction writing.
Black physicians have been practicing in the U.S. since 1850 when slavery was legal in the South. Up to nine doctors were recorded and known to be practicing that year in a few Northern states. This essay expands on the experience of Black doctors working in the South as they struggled to combat racial discrimination and segregation within the American medical system. Howard University Medical School and Meharry Medical School were two of the first schools created to train Black doctors after the Civil War. But after obtaining a medical degree, Black doctors were forced to set up small, independent practices because they were not permitted to work in hospitals that were already established. While providing services to Black people in the community, they often had to settle for receiving other forms of payment in order to sustain their business, and provide more than just medical services if they wanted the community to thrive overall. H.A. Callis wrote,
“The Negro physician rarely finds himself so situated that he can devote his talents and energies solely to the professional pursuits of medicine. He is the humanitarian in the broadest sense of that term” 
Black physicians were also handicapped by Black members in the community who refused to seek service from Black doctors because they preferred White ones. White physicians refused to acknowledge Black doctors as capable of practicing medicine and some Black patients refused to support them. My research describes part of the experience Black physicians had working in the South up until the Civil Rights Movement. I argue that the Black physician’s experience has been one of segregation and self-sufficiency while pushing to gain equal opportunity and acceptance into American medicine.
The high death rate among Black soldiers during the Civil War is what prompted the construction of the first medical schools designed specifically to educate Black students. There were separate medical units for Black and White soldiers, and Calvin Smith wrote that “thousands of black soldiers died of wounds from which white soldiers recovered, because the War Department rarely assigned enough competent doctors to black units”.  Black physicians were graduating from medical school in very low numbers at the time, so the need for them was high. The first Black man to receive a degree from an American medical school was David Jones Peck. He graduated from Rush Medical School in Chicago in 1847. The next was Rebecca Lee Crumpler, who graduated in 1864 from the New England Female Medical College.  After the war, with the help of White allies, Howard and Meharry were built and Black people begin to train in their own schools. Howard University Medical School was established in 1869, six years after Emancipation in Washington, D.C. Less than a decade later, Meharry Medical College was founded in 1876 in Nashville, Tennessee.  However, Black doctors had no idea they would be “handicapped” by “racial prejudices and superstitions of the white medical community,” after graduation. 
After obtaining their medical degrees, Black doctors were still excluded and segregated in the field. While internships and job opportunities were abundant for White students, Black doctors were “excluded from white hospitals in the South,”  and “denied public hospital privileges” too.  Their degrees held little to no value because they had nowhere to practice. They were also excluded from the American Medical Association which meant they had no access to the new knowledge and medical technology circulating in the field. Thus, many Black doctors set up their own private practice to service Black communities. Many of them settled in the South because of the large Black population. By the 1900’s, there were many Black doctors practicing in the Southern part of the U.S., but they were pretty much on their own.
Many Black physicians working in the South were self-sufficient and working to provide health care to the poorest population of Black people. While opening a small practice as a Black doctor in a Black community seems promising, they received little to no financial support from the government. Instead, their hospitals were funded by churches or other private organizations.  They also had trouble gaining income because some people refused to utilize their services. There were Blacks who preferred to pay White doctors because they had been socialized to believe that White doctors were more skilled. They believed “white doctors had better training and possessed superior equipment and facilities than their black counterparts.”  In Arkansas specifically, Black medical practitioners were serving poor sharecroppers who could barely afford to pay their medical bills.  Frequently, Black physicians provided other services such as groceries and shoe services out of their doctor’s office to help attract customers.  They used many different creative methods to sustain their establishments while they provided care to the poor.
The Great Depression proved to be another huge setback for doctors practicing in the South during the twentieth century. In 1929, the Great Depression left many doctors’ offices empty and some eventually closed down for good. The unemployment crisis and dried crops meant that less people could pay to see a doctor. Home remedies were used a substitute for formal doctor visits. One man described the scarcity of patients in doctors’ offices by saying “it is better to play checkers than to go crazy waiting for patients who don’t appear.”  There was job competition from Mexican migrant workers and White workers arriving, so the large Black population began to diminish. There was no work, money or patients. Doctors continued to rely on other sources of income. They were offered payments in “livestock” and “farm produce” as means for compensation. 
Dr. Beadie Connor documented his experience practicing as a Southern physician during the Great Depression in a personal journal. Educated at Meharry, him and his wife settled in Waco, Texas for him to start practice. He wrote about how purchasing his first car greatly enhanced his business as a doctor because it enabled him to accept emergency calls and night-calls. He would then drive to the patients house in the middle of the night to care for them. He also wrote that there was a lot of competition from White physicians. As an effort to compete with them, Connor set up something called contract-medicine where he would charge patients just $1.50 a month. With this fee, they could “receive free doctor’s visits and necessary medications under the health care plan.”  On top of the already difficult task of maintaining business, doctors struggled to keep their offices open during the Great Depression and make a living for themselves.
During World War II as Black and White physicians worked together to heal wounded soldiers, Black doctors were continuously humiliated by White workers in the War Department. Even during World War II in 1940, there were still separate war units.  Black professionals began to publicly protest the humiliating treatment by the War Department by this time and negotiate ideas of change.  For instance, “…black physicians raised issues ranging from compensation for civilian black physicians who administered physical examinations to draftees to a demand for equal service on induction boards.”  They also complained of not receiving enough resources in their unit to black soldiers. Their resistance was successful as they were provided the adequate materials to fully operate on Black soldiers. Some of the tactics used by the Black professionals used to protest during WWII can even be identified in the methods used by those of the Civil Rights Movement.
Despite the many setbacks Black doctors encountered while working in the South, they still managed to improve the lives of many and make contributions to American medicine. In addition to providing medical services, they founded community centers to provide resources for families and educated them on how to take better care of their health. They also discovered some of the greatest advancements in history. One example is Dr. Charles Drew of Washington D.C. who was a plasma researcher. “During World War II alone, his work allowed blood storage for transfusions that saved many thousands of lives.”  He figured out that blood plasma could be processed and stored in order to use again later if it was hydrated properly. Before Drew’s discovery, unprocessed blood only lasted about a week.  In 1893 Dr. Daniel Hale Williams performed the first successful open heart surgery. He also opened Provident Hospital and Training School for Nurses in 1891 in Chicago. It was “the country’s first interracial hospital and nursing school.”  Then he contributed to the creation of the National Medical Association in 1895 which was created because Black people were excluded from the American Medical Association.
Black physicians had great difficulty navigating America’s medical system prior to the Civil Rights Movement in the 1960s. They could only serve other Black people and often times they needed save up money to start up their own practice because they could not secure a job. They were left to serve communities so poor that they barely received monetary pay for the job. White doctors consistently viewed Black doctors as inferior and implemented segregated war units during World War II to show their disdain. Black doctors were providing for patients who had barely any knowledge of their health in the South, and they received little to no help from the government or community to support their practices. According to a study done by the Journal of Blacks in Higher Education, Howard and Meharry were still responsible for producing most of America’s Black physicians in the late 90s. Black doctors and researchers continue to endure other forms of discrimination and segregation while practicing today, but American medicine would not be same without their contributions.
 H.A. Callis, “The Need and Training of Negro Physicians,” The Journal of Negro Education 4 (1935): 40.
 C. Calvin Smith, “Serving the Poorest of the Poor: Black Medical Practitioners in the Arkansas Delta, 1880-1960,” The Arkansas Historical Quarterly 57 (1998): 289.
 Milton Moskowitz, “The Black Medical Schools Remain the Prime Training Ground for Black Doctors,” The Journal of Blacks in Higher Education, 5 (1994): 72.
 Smith, “Serving the Poor,” 289.
 Ibid, 288.
 Keith Volanto. “The Life and Work of Dr. Beadie Eugene Conner: An African American Physician in Jim Crow Texas,” The Southwestern Historical Quarterly 115 (2012): 266.
 Ibid, 274.
 Callis, “Training of Negro Physicians,” 39.
 Volanto, “Life of Beadie” 268.
 Smith, “Serving the Poor,” 297.
 Ibid, 307.
 Lorenzo J. Greene, “Economic Conditions Among Negroes in the South, 1930, as Seen by an Associate of Dr. Carter G. Woodson,” The Journal of Negro History 64 (1979): 271.
 Smith, “Serving the Poor,” 298.
 Volanto, “Life of Beadie,” 271.
 Darlene Clark Hine, “Black Professionals and Race Consciousness: Origins of the Civil Rights Movement, 1890- 1950,” The Journal of American History 89 (2003): 1282.
 Ibid, 1293.
 Ibid, 1286.
 “African American Medical Pioneers,” PBS. Access May 11, 2016. http://www.pbs.org/wgbh/amex/partners/early/e_pioneers_txt.html
Greene, Lorenzo J. “Economic Conditions Among Negroes in the South, 1930, as Seen by an Associate of Dr. Carter G. Woodson”. The Journal of Negro History 64, no. 3 (1979): 265–73.
Moskowitz, Milton. “The Black Medical Schools Remain the Prime Training Ground for Black Doctors”. The Journal of Blacks in Higher Education, no. 5. (1994): 69–76.
Thomas, Karen Kruse. “The Hill-burton Act and Civil Rights: Expanding Hospital Care for Black Southerners, 1939-1960”. The Journal of Southern History 72, no. 4 (2006): 823–70.