The Missouri Medical Diploma Mill

Part 3: The final chapter

One week after Harry Brundidge and the St. Louis Star broke the story of Missouri’s medical diploma mills, Gov. Arthur Hyde invited a nationally prominent medical educator, Dr. Frederick Waite, to conduct “an immediate investigation” of all the state’s medical schools. Waite moved quickly and with the assistance of members of the Missouri Board of Health set forth review criteria and a rapid schedule for the visits. Collectively, they assembled a team for on-site inspections of all six of Missouri’s medical schools. The resulting report characterized the Kansas City College of Medicine and the St. Louis College of Physicians and Surgeons “not reputable under the intent of the [state’s] law.”

Waite’s choice of language (cited above) reflected an earlier twist to the story that underscored the connections and influence of the two diploma mill schools with sympathetic (or perhaps careless? corrupt?) legislators. The Missouri Board of Health had long refused to recognize these schools and license their graduates for practice based upon their substandard facilities and instruction. Both were categorized as substandard Class C schools by the AMA Council on Medical Education. But in 1921, a subtle change in state law directed the board to license graduates of “legally chartered” rather than “reputablemedical schools. This subtle language difference mattered significantly as both schools held a valid charter issued by the state of Missouri. Despite protests from the state medical association, the governor signed the bill into law. The Missouri Board of Health had no choice but to consider individuals holding a degree from either school as eligible for licensure—provided they pass the board’s licensing exam.

Thus, at the time of Waite and board’s report to the governor on the state’s medical schools in late 1923, the Missouri Board of Health lacked authority to deny a medical license to the Kansas City and St. Louis graduates. The report of Waite and the board characterizing the schools as “not reputable under the intent of the law” carried no legal force though it served as a public relations weapon against the schools—an effective one amidst the massive publicity triggered by the case.

adcox front page

The mountain of evidence secured in the fall 1923 and subsequent confessions of key witnesses like Robert Adcox and Williams Sachs brought matters to a head in 1924.  The governor turned to Waite once again to conduct an investigation—this one into the operations of the state’s board of health. Working rapidly, Waite’s interviews and assessment of board practices culminated in a report and a set of recommendations early in 1924. The board agreed to implement several operational measures (recommended by Waite) designed to bolster the integrity of their licensing decisions.  The board agreed that verification of license applicants’ personal information and credentials would be handled by one designated staff member. The board also agreed that, while the investigation by authorities played out, no Kansas City or St. Louis College graduates would be admitted to the examination. By June of that year, both protocols had been violated by the Secretary for the Health Board, Dr. Cortez Enloe.  This may not have surprised knowledgeable insiders, or even Waite, as earlier Enloe had declined to participate in any of the board’s visits to the Missouri medical schools in late 1923.

Despite mounting criticism and calls for his ouster, Enloe held fast to his position as board secretary. He only relinquished this role (though still remaining on the board) until further revelations reached the press concerning his association with a physician named Ray Horton. Horton presented himself as a “personal and political friend” of Enloe and in a later confession, admitted using this connection as a means for soliciting money from the Kansas City school and its degree holders with a promise of access to a Missouri license. The implication was clear: Enloe had some sort of financial relationship with the school through Horton. Governor Samuel Baker finally dismissed the entire board of health in September 1925. However, Enloe’s close friendship with Gov. Baker served him well. He managed to escape formal charges and the governor subsequently appointed Enloe to oversee the state’s Board of Prisons.

For his part, Harry Brundidge probably deserved, but did not receive, a Pulitzer Prize for his investigative journalism. It was, however, the start of a stellar career that saw him making headlines many times over…often as a result of his crime stories. His career brought him face to face with murderers, bootleggers, kidnappers, crooked cops, reporters “on the take” and nationally-known personalities like Al Capone and J. Edgar Hoover. (Below: Brundidge seated left of J. Edgard Hoover)

In a radio broadcast nearly three decades later, Brundidge reflected on this period of his journalistic career that frequently brought him into contact with “criminals.” The jaded reporter evinced surprising sympathy for these men.

 “At one time in my life I wrote a great deal about crime and criminals. I don’t know how many criminals I came to know personally while I was a newspaper man…the number is large. It has not been always easy to draw the line of behavior where it belonged, between friendship and the rights of society. But I did my duty on both sides of the line. I had my friends, and I helped the law.

What has not been hard has been to know that there is no line between people. They are all basically alike, all have good in them, all have the potentiality of failure.

I have known some criminals very well indeed. I have known, too, that I was no better than they were, I was only more fortunate. And because of this contact with criminals I have been privileged to have more friends than persons usually have. And the friends I have had, some of them, have been better friends because they weren’t able to make friendships with those on my side of the line. They knew I believed they had good in them. They knew I trusted them. So they trusted me. I am rich because they did.”

retired

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 (ahead of print publication October 2018)

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

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