In the early 19th century, J. Marion Sims, a graduate of South Carolina College and future prodigious surgeon, returned home to his family and announced that he was going to become a physician. His father replied: "If I had known this, I certainly should not have sent you to college." He went on: "It is a profession for which I have the utmost contempt. There is no science in it. There is no honor to be achieved in it; no reputation to be made."

Hyperbole aside, Sims's father recognized the lowly nature of the physician's craft in the early 1800s. At the time, medicine was replete with fraudsters and hucksters, few proven medications existed for doctors to offer ill patients, becoming a physician required little education, and physicians often had to double as pharmacists or midwives to pay the bills.