Gosline, S; (2013) The physician as entrepreneur: examining medical business patterns through the career of S Andral Kilmer MD (1840-1924). Doctoral thesis , UCL (University College London).

Abstract

How a medical entrepreneur functioned daily in America's nineteenth- and early twentieth-century marketplace is examined in this study of an adept medical entrepreneur, S Andral Kilmer, MD. Although the "medical marketplace" came into vogue in mid-1980s history of medicine, historians have still done little to unpack its scale, scope, or dynamics. The "who could fall for that" theme pervades literature on quackery, only rarely admitting that we remain an ever gullible public, still taken in by miracle cures. Recently, Takahiro Ueyama's Health in the Marketplace has shaken this orthodoxy of medical historiography while re-invigorating a dormant marketplace discourse. Since Victorian purveyors of medical commodities aspired to scientific status, confusion abounds concerning the shady border between regular and irregular practitioners, but Ueyama's study stops short of fully illuminating that commercial juncture. This thesis unpacks that regular/irregular overlap with substantive and methodological contributions, particularly through analysis of advertising imagery, legal and travel related records, and patient case records. To ground the work, make the scale manageable, and provide an in-depth core, the focus is on the career of one physician who identified himself as the "Invalid's Benefactor" and "Cancer's Conqueror," while his enemies branded him an itinerant quack on the basis of his penchant for self-promotion. Although trained by leading regular physicians, Kilmer settled upon an eclectic practice, ideologically oriented to the physio-medical movement. His life encapsulates a paradox of contemporary fame versus historic obscurity in the fickle and faddish realm of American medical consumerism. This examination of how a medical entrepreneur navigated the changing healthcare marketplace is relevant and timely. Despite the twentieth century tendency for physicians to be employed in hospital or research settings, self-sufficiency persists as a foremost characteristic of American medicine, and young physicians are increasingly encouraged to be entrepreneurs.

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