Final answer:
Physicians became central in hospitals due to their advanced training, management roles, surgical performance, and decision-making authority on patient hospitalization. Black physicians, facing segregation, created their own institutions and professional associations to advance medical care and training for African Americans.
Step-by-step explanation:
Physicians began to play a dominant role in hospitals mainly because they were the most highly trained employees, they managed most of the hospital operations, they performed an increasing number of surgeries, and they had the authority to decide where to hospitalize their patients. Over time, the U.S. healthcare system faced significant changes, including a push towards efficiency and mass production, a phenomenon seen in the 1990s with hospital mergers. Meanwhile, segregation and racial discrimination posed obstacles for Black physicians and patients, often excluding them from white hospitals and leading to the establishment of Black-operated hospitals. Examples include Provident Hospital in Chicago, which was among the first with interracial staff and one of the earliest to conduct open-heart surgeries. Efforts by organizations such as the National Medical Association and the National Hospital Association were instrumental in advancing the professionalization of Black medical practitioners and the standards of Black hospitals. Nevertheless, Black physicians struggled for acceptance and faced segregation, particularly in the South, affecting where they could work and whom they could treat.