Anti-immigrant stance led to Wyoming’s physician shortage

(Opinion) — The current national controversy about immigration restrictions is nothing new to Wyoming which, in the 1920s and ‘30s, debated the merits of allowing what many considered “undesirable” races into the state to practice medicine.

The Equality State enacted anti-immigration laws targeting physicians and their families who weren’t considered “100 percent American,” even if they were born in the U.S. Many were deemed by the state to be “inferior” Americans.

The rural state of Wyoming clearly had a shortage of doctors at the time, and the ones who did set up their practices here in the early 20th century didn’t want competition. Combined with xenophobic fears that some races shouldn’t be encouraged to live in Wyoming, state lawmakers were pressured to establish license regulations to keep foreign-trained physicians from working in the state.

Wyoming historian Phil Roberts recently recalled this sad example of the state’s intolerance for minorities and directed me to an excellent Spring 1997 Annals of Wyoming article that recounted the physician controversy.

Fencing Out the Foreigners, by Susan Macki and Eric D. Kohler focuses on a long forgotten anti-immigration fight that should be revisited in light of Donald Trump’s religiously bigoted proposal. The anti-immigrant sentiment here nearly 100 years ago led to a physician shortage in Wyoming that was a factor for at least two generations, and may still impact the situation today.

Wyoming wasn’t alone in this devious plan. We joined 28 other states with the same illogical goals, which was the intellectual equivalent of purposely shooting yourself in the foot while knowing you may not be able to find someone qualified to patch you up.

The already difficult task of recruiting doctors to such a rural place as Wyoming made the impact of the proposal greater here than it was in many states.

Macki and Kohler noted the nation had become intensely isolationist in its political philosophy in the years between the two world wars. Much of the country just wanted to be left alone and not be involved in anyone else’s problems. After World War I the last thing the U.S. wanted to do was import the struggles of other nations.

In several states, including Colorado, a leader in the anti-immigration movement was the Ku Klux Klan. While there was some early Klan activity in Wyoming, the state didn’t have an official KKK organization until 37 Klanswomen incorporated in Cheyenne in the 1920s.

“The state’s xenophobes were confident that they formed a majority, and confident of the propriety of their insular movement within Wyoming and the nation,” the authors wrote.

In 1910, a Carnegie Foundation study by Abraham Flexner addressed “educational deficiencies” in the nation’s medical schools. The Flexner Report convinced the powerful American Medical Association (AMA) to begin rating medical schools and classifying them according to stringent rules aimed at barring graduates of “inferior” institutions from taking state medical licensure examinations.

Macki and Kohler noted that Surgeon General W.C. Braisted told a national AMA convention in 1920 that the physical integrity of the American race was necessary “for survival in its struggles with its rivals.” Braisted opined that the white race was being weakened due to its low birth rate and the physical defects of its males.

Braisted called for a probe into the background of medical school applicants that would keep diplomas from being awarded to “physical or moral runts.” He also assailed medical students who could not speak “proper English.”

Medical schools responded by creating quotas based on applicants’ ethnic backgrounds to supposedly “upgrade” the practice of medicine in the U.S. The authors said the quota system “had devastating effects on the children of Eastern and Southern European immigrants.” By 1930, except for a small percentage of Jews and Italians, American medical schools had effectively barred the “undesirables.”

These unacceptable students, particularly Jewish males, traveled to Britain, Scotland, Ireland, Switzerland, Germany and Austria to get their medical training.

While American graduates of prestigious European medical schools were once held in high esteem and had institutions and communities fighting to obtain their skills, that was not  the case in Wyoming. When the grads returned home after completing their medical education, they couldn’t be licensed in the state.

The unlikely leader of Wyoming’s effort to make sure physicians here were 100 percent American was University of Wyoming professor and well-known historian Grace Raymond Hebard, one of the most influential people in the state. How influential was she? Macki and Kohler wrote that Hebard was so close to GOP legislative leaders she was routinely asked to comment about all bills before they even went to the full Legislature.

The state’s 18th Legislature passed a bill in 1925 that required candidates for medical licensure in Wyoming to be American citizens with credentials obtained by AMA-approved medical schools — none of which were on foreign soil. Hebard was the face and voice of the lobbying campaign.

At forums around the state she talked about the racial characteristics of recent Wyoming immigrants. Hebard considered the Nordic race to have the superior qualities America needed, while people of Alpine and Mediterranean descent were considered much less compatible with American ideals.

Who would have made the perfect American physician? Hebard thought aviator Charles Lindbergh had the desired “racial blood.” She attributed his courageous deeds in the air to his combination of Swedish, English and Irish blood.

In addition to state licensure legislation, Hebard was an active proponent of the 1924 Reed-Johnson bill in Congress to impose severe national limits on further immigration. No matter how long they lived in the U.S., the Annals authors wrote, Catholics, Jews and Negroes were not considered 100 percent American. That designation was reserved only for Caucasian Protestants.

The Klan’s influence on the state licensure issue is difficult to determine. But Wyoming was well represented at national KKK meetings, where members could hear first-hand Grand Kleagle Hiram Evans’ explanation of the group’s radical position on immigration.

In a newspaper article published throughout Wyoming, Evans described Negroes as “savages” and claimed Jews had “never emerg[ed] for a real intermingling with America.” Catholics, he wrote, were undesirable because they were illiterate and owed allegiance to Rome.

It didn’t take long for Wyoming to achieve its absurd goal of preventing highly qualified, foreign-trained physicians from becoming doctors in the state. But Wyoming paid a high price for its prejudices by making its existing physician shortage even worse for many years.

Meanwhile, states like Colorado, South Dakota and Virginia took full advantage of the sudden influx of foreign-trained physicians, especially Jews who fled Nazi racial persecution, to significantly upgrade the quality of their medical providers.

Because of Wyoming’s own brand of racial and religious persecution, the state lost the privilege of having many fine physicians practice here. It’s a good example of what can happen when people like Trump — who want to punish entire religions or races — achieve political power by capitalizing on people’s bigotry and fears.

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