THE CREATION OF THE AMERICAN
MEDICAL ASSOCIATION
By 1800, the still new United States could boast of five recognized medical schools, all in the eastern states. Over succeeding decades medical practitioners seized opportunities to form new medical schools, appoint themselves professors, and derive further income from student fees. Between 1830 and 1847 the number of medical schools doubled. To discourage dropouts, pre-med requirements were negligible, the two-year curriculum was reduced to 16 weeks a year (some going to 13 weeks), and final exams were geared to pass most of the students.
Many doctors saw this trend as damaging to the profession. Dr. Nathan Smith Davis of the New York State Medical Society was especially concerned. Smith, born in poverty in a log cabin, obtained a medical education at a long-since defunct school in Fairfield, N.Y., opened a practice in Binghamton, engaged in 
Nathan Smith Davis MD
(Wikipedia)
teaching, and became active in the State Medical Society. Learning about earlier unsuccessful attempts to standardize medical education, he worked to convene a national meeting to address the problem.
Davis, through the N Y Society, invited delegates from every state medical society and each medical school in the country to attend a conference to establish educational standards and to consider the formation of a national medical society. In spite of opposition, the organizers met in the Medical Department of NYU on May 5, 1846. Eighty delegates attended, representing sixteen states (of 25 at the time). Efforts by naysayers to cancel the meeting were defeated decisively, ending further resistance to the idea of a national organization.
In short order, officers were elected, rules established, and, responding to the broadening interests of the group, committees were organized to report at future meetings on topics such as education, medicine, surgery, hygiene (public health), medical ethics, medical literature, and the like. Medical education remained a leading issue and the delegates were expressly asked to consider the thorny question of whether professors in medical schools could also issue licenses, a common practice at the time.
The following year, 1847, delegates to the first “National Medical Convention” met in the Academy of Natural Sciences in Philadelphia to formalize the national association. The delegates 
Academy of Natural Sciences of Philadelphia (Graham's Magazine, 1852)
chose “The American Medical Association” as their name and drew up a constitution designed to be as representative as possible. Two classes of membership were adopted. The largest group consisted of delegates, some chosen by state and local medical societies (the number based on membership tallies), and others chosen by medical schools, hospitals of at least 100 beds, and other medical institutions (usually two per institution). Along with delegates from areas without medical societies, they comprised the voting members and served one-year terms. Another delegate class, permanent members, comprised those who wished to continue their association with the AMA as nonvoting members. Officers served for one year and the same city could not host the meetings twice in a row. The first president of the AMA was Nathaniel Chapman, Professor of the Theory and Practice of Medicine at the University of Pennsylvania. He was chosen because “of his age, his high attainments, and his
Nathaniel Chapman (Wikipedia)
position as one of the oldest and most eminent teachers in the Union,” and not because of medical innovations or research. His biographer describes him as a “friendly anachronism, venerated for his age and position but ignored as a medical theorist.”
The new AMA focused on medical education. The delegates passed resolutions extending the teaching period to three years, with at least two years of six-month lecture periods and three months of dissection, and stipulating attendance records. Pre-med requirements included adequate basic science and mathematics, proficiency in English, enough Latin and Greek to read medical tracts and write prescriptions, and testimony of good moral character. The question of using outside examiners for license qualification, furiously resisted by many medical school delegates, went to a committee for further study.
The Convention adopted a medical code of ethics that was virtually a reprint of the widely known and valued 1803 work by the British physician, Thomas Percival. A resolution encouraging the registry of births, deaths, and marriages passed easily, various standing committees were assembled, and Baltimore fixed as the first annual meeting place for the new-born AMA.
The Baltimore meeting in 1848, the first annual meeting, opened with a speech by the new president, Nathaniel Chapman, who established the convention of serving a one-year term. The just-approved requirements for pre-med education were upheld in spite of complaints, even by Harvard faculty, that they were too severe (though there was no ability to enforce them). Furthermore, the delegates added hospital bedside teaching as another obligation. A report on the growing problem of adulterated drugs imported to the U.S. (after Europeans tightened their laws) startled participants. Major problems cited were Peruvian bark (sent after the quinine was leached out), adulterated quinine, rotten or spoiled rhubarb root, and diluted opium. Oliver Wendell Holmes reported on the sad state of American medical literature and the sparsity of translations of good European articles. 
Transcription of the first annual
meeting of the AMA (Trans of
the AMA, v1, 1848,Hathi Trust)
The surgical section devoted generous time to the new anesthetic agents, ether and chloroform, introduced in the previous two years. New developments in medicine, vital statistics, public health reports, and indigenous medical botany filled the remainder of the agenda.
In spite of disputes over issues of education, reasonable harmony prevailed and leaders in medicine leant their support. The AMA endured. Nathan Smith Davis, the driver of the early efforts, had skillfully guided the organization through the birth process. He later accepted the chair of Physiology and Pathology at Rush Medical College. However, when the dean of the school refused to institute some of the AMA medical school requirements, Davis and sympathetic faculty left and founded a new school, the Medical Department of Lind University, which eventually morphed into Northwestern University Medical School (now the Feinberg School of Medicine). Davis later served as president of the AMA, editor of its journal, and wrote a history of the AMA up until 1855.
SOURCES:
Fishbein, M, A History of the American Medical Association 1847 to 1947. 1947; W.B. Saunders.
Davis, N.S., History of the American Medical Association from its Organization up to January 1855.1855; Lippincott, Grambo & Co.
The Transactions of the American Medical Association, Instituted 1847. v 1, 1848; American Medical Assoc.
Code of Ethics of the American Medical Association Adopted May, 1847. 1871; Turner Hamilton.
Leake, C. D., Percival’s Code: A Chapter in the Historical Development of Medical Ethics. 1923; American Medical Assoc.
Obituary (Davis), Science, 1904; 20 (NS): 237-40.
Richman, Irwin, The Brightest Ornament: A Biography of Nathaniel Chapman, M.D. 1967; Pennsylvania Heritage, Inc, Bellefonte.
