ABSTRACT
This chapter assesses Puerto Rican physicians’ struggle for professional status and autonomy from the colonial state in four ways. First, in order to distinguish between state- and market-related aspects of this struggle, it compares the ideological meanings supporting physicians’ struggle for professional status under Spanish and US colonial rule. Second, the chapter elucidates the intra-professional challenges to physicians’ markets and status that increased significantly in the years following the 1898 military invasion. Third, it considers how the terms of institutional conflict and competition between physicians and the state shifted from the Spanish to the US colonial state. Finally, the chapter emphasizes physicians’ actions to support their professional status by discussing how they articulated their ethnic difference, formed an independent medical association, and subsequently incorporated this association into the American Medical Association. It concludes with a discussion of the implications these fundamental transformations had on the subsequent development of medicine and public health in Puerto Rico.
