The increasing complexity also demanded that medical education and the profession itself become more formalized and unified. Hearkening back to the Hippocratic tradition, the AMA, which was established around 1846, identified as one of its primary objectives “to bear emphatic testimony against quackery in all its forms.”1 Soon, American medical education became standardized. While the first medical schools were opened in Philadelphia and Boston during the latter half of the 18th century, by the end of the 19th century there were over 130 medical schools, and 96% of them required three or more years of training.2 Beyond formalized education, individual states imposed their own licensing requirements on physicians. Thus, the American physician, licensed by the state and holding a reputable medical degree, could now legitimize his claim to authority. Because of this, toward the end of the 19th century, even American patients, with their liberal-individualistic ideals, were willing to submit to the authority of, and be obedient to, their trusted physicians.5 At that point, American physicians attained the status that seemed to be promised by Percivallian ethics and that was essential to the survival of the beneficence model.