Final answer:
The medical profession remained a trade in pre-industrial America mainly due to the lack of strong oversight from professional medical organizations, the guild system prioritizing individual standards, the focus on earning in key industries rather than professional development in medicine, and barriers to medical education and patient access, especially for low-income groups.
Step-by-step explanation:
The medical profession remained a trade rather than a regulated profession in pre-industrial America due to a number of contributing factors. First and foremost, the absence of strong professional medical organizations meant there were no centralized bodies to oversee and standardize practices.
As referenced in the snippets, the American Medical Association (AMA) was established in 1847, but it lacked the authority to effectively regulate medical practices during its early years. Consequently, this allowed for the continuation of varying, and sometimes harmful, health reform directions and treatments provided by quack doctors.
Additionally, given the guild system in place, where each skilled group maintained its own standards, the concept of a unified medical profession was more challenging to establish. Within this context, individual groups focused on enforcing their own high professional standards rather than collectively uplifting the medical profession as a whole.
The demand for both skilled and unskilled labor, as mentioned, centered around industries like shipping and domestic services rather than the professionalization of medicine. Workers generally aimed to earn more rather than focusing on professional enhancement or regulatory oversight.
As a result, medicine was just one of the many trades people could pursue, without a clear path to professional status. Furthermore, the disparities in health among different social groups, as well as challenges in access to medical education and patients, particularly in low-income sectors, also likely contributed to the slow development of medicine as a profession.