Part 1: “Harry, why don’t you become a doctor?”

Harry Thompson stepped out of his rented room in St. Louis on the morning of August 13, 1923, waved to the postman walking past and called out to him—“Can you tell me where the nearest doctor lives?” The postman offered a hurried, “Right there!” pointing several houses down the street toward a man watering plants on his front porch. Dr. Robert Adcox heard the exchange and looked up to see Thompson making his way toward him. After a brief discussion and despite some initial reluctance, Adcox agreed to treat Thompson’s sore throat.

After a follow-up visit and several increasingly friendly conversations, Dr. Adcox presented his young patient with an opportunity—“Harry, why don’t you become a doctor?” Thompson responded with a chuckling protest, citing the obstacles to such a career move, including his lack of a high school diploma. Adcox brushed aside such concerns. “Bunk, Harry, my boy! You wouldn’t have to go to school to become a doctor.” He then explained how a high school diploma could be obtained and all obstacles removed to securing a medical diploma and a license to practice. Skeptical but intrigued, Thompson pressed for details. A smiling Adcox said, “Harry, a good magician never reveals how he does his tricks…be ready to go to Kansas City with me tomorrow night…I’ll show you how it’s done.” Two months later, Harry Thompson (aka Harry T. Brundidge, reporter for the St. Louis Star newspaper) possessed a high school certificate, a medical diploma (backdated to 1916) and a medical license.

This episode became the opening salvo in Brundidge’s exposé series launched October 15, 1923. The full-story of the Brundidge’s investigation played out on the front page of the Star almost daily over six weeks. The Star related how medical diploma mill activities centered primarily around two Missouri schools (Kansas City College of Medicine and Surgery; St. Louis College of Physicians and Surgeons) served as a pipeline to licensure in several states. The Star also revealed how the main players in the Missouri-based diploma mills (Drs. Robert Adcox, Ralph Voight, Date R. Alexander, Waldo Briggs) were part of a loose national network of medical diploma mills that once touched all regions of the country.

The Star’s first headline, ‘Ring Selling Medical Diplomas throughout the U.S.’ triggered massive national interest, presenting a major embarrassment to medical education and licensing in the United States. That this story has been conveniently forgotten should not be surprising. Fallout from the scandal and its resulting investigations culminated in the dissolution of one medical licensing board (Connecticut), the reorganization of another (Missouri) and a fight for existence in a third (Arkansas). A fourth board (Florida) was spared this ignominy only because earlier malfeasance led that state’s governor to dissolve it before the Star’s story broke. The Star’s reporting brought America’s Class C medical schools outside the whispered circles of medical education and into a national spotlight. A few of these schools operated so far on the fringe of U.S. medical education as to be little more than diploma mills—either explicitly through their design or as once legitimate institutions that drifted into de facto diploma mill activity. These schools represented dying institutions; Harry Thompson Brundidge and the St. Louis Star eagerly helped  to hasten their demise.

The 1923 exposure of the medical diploma mills in Kansas City and St. Louis concluded a sordid chapter in American medical education that saw similar institutions dotting the landscape. Though the most notorious 19^th century medical diploma mill (Eclectic Medical College of Pennsylvania) predated the post-Civil War rise of medical licensing laws, most of its rivals in the trade originated alongside the emerging medical legislation in the last quarter of the century. All regions of the country confronted medical diploma mill activity especially in the period before most medical boards had the authority to approve medical schools and thus restrict licensing to graduates of bona fide schools.

The west coast saw medical diploma mills in Washington and California. The Pacific College proved an especially persistent and egregious participant in the diploma trade drawing a protracted effort from the California medical board to force its closure.

New England witnessed its share in the illicit trade. Lax chartering laws in Massachusetts allowed medical diploma mills to flourish briefly in that state: Bellevue Medical College of Massachusetts, American University of Boston, Excelsior Medical College, Druidic University, etc. New Hampshire and Vermont authorities confronted medical diploma mills or fraudulent institutions functioned as well.

From the Atlantic to the Midwest, medical diploma mills operated at various times in the District of Columbia, Michigan, New Jersey, New York, Pennsylvania, Ohio and Wisconsin. Several of these operations originated with co-conspirators in John Buchanan’s Philadelphia diploma mill: Henry Stickney with New England University and Henry S. Thomas’ Detroit Eclectic Medical College. Others emerged from institutions originally founded with apparently legitimate purposes before lapsing into the diploma trade. This appears to have been the case with two similarly titled Cincinnati area schools: Physio-Medical College and the Physio-Eclectic Medical College. More than a dozen medical diploma mills plagued Illinois at various times especially the multiple ventures of Johann Malok in the1890s.

The problem persisted primarily because it represented a potentially lucrative business. The Wisconsin Eclectic Medical College’s owner was arrested in 1897 after lucrative sales earning tens of thousands of dollars. All of these schools were among the forty institutions identified as “fraudulent” by the AMA Council on Medical Education in its review of U.S. medical colleges published in 1918.

By 1923 the vast majority of these schools had closed or been publicly identified such that their graduates were nearly unlicenseable. Shutting down the remainder should have represented nothing more than a clean-up exercise. Not so!

I’ll continue the story in Part 2 and share how Harry Brundidge’s story implicated medical licensing boards in Arkansas, Connecticut and Florida.

The views expressed are those of the author and do not necessarily reflect those of the Federation of State Medical Boards.

Sources:

This multi-part series is derived from my article “An Underworld in Education: The Demise of Missouri’s Medical Diploma Mills,” Social History of Medicine 33(1): February 2020. To access the pdf version of the full article see https://academic.oup.com/shm/article/33/1/106/5124320?guestAccessKey=e4a2952d-f0be-45a6-b4f3-92ee20bdfb7e