Changes

Even though the bill had passed, the OSMA still feared that the governor would veto it. Governor Sylvester Pennoyer had expressed several concerns about the bill. If he chose to veto the bill late in the legislative session, it would have been at least two years before the bill could be reintroduced. Fortunately for the OSMA, Pennoyer decided not to veto it. Instead, Pennoyer issued a non-signing statement arguing that the bill should have been vetoed because it gave the medical board too much power to take away a physician’s diploma for unprofessional conduct. These broad powers were not circumscribed because the act failed to define dishonorable conduct, but Pennoyer instead decided “to obviate any difficulty by appointing as examiners men known to be cool-headed and conservative.”<ref> “The Governor Dodges. The Medical Bill Becomes a Law Without His Signature – His Excellency longed to a farewell shot at the bill, but he concluded to check the veto impulse and trust in luck.” <ref><i>The Oregonian</i>, Feb. 28, 1889.</ref>

After almost fifteen years of failure, the OSMA finally succeeded in passing a regulatory act by paying a two-hundred dollar bribe from the “corruption fund” to a legislator who then passed an amendment to protect his own medical practice. Additionally, the remaining one-hundred-and-five dollars were distributed to other legislators on Pope’s suggestion. Despite Pope’s self-dealing, his modifications to the bill made it more palatable to Oregon physicians who were practicing without diplomas. Pope’s concerns were similar to other physicians in the state, and those doctors would have opposed the 1889 bill without those changes. The conclusion that the three-hundred-five dollars raised by the association was intended for bribes is unavoidable. It is not surprising that Strong was cagey about explaining what the money was for. Strong also acknowledged that even with Pope’s help and the OSMA members’ money, getting the bill passed was extremely difficult; “[i]f they knew the way that committee worked, the difficulties that arose, and the pressure brought to bear, the thumb screws we used here and there of one kind or another.”<ref><i>Proceedings Sixteenth Annual Meeting</i> (1889): 208.</ref>

Under the promulgated standards, Dickson postulated that graduates of forty of the existing one-hundred-and-thirty-five American medical institutions would be forced to take an exam under Oregon law. The 1891 revision also placed physicians who registered with the county clerks under the control of the medical board. Under the 1889 Act, the board lacked jurisdiction over these physicians and could not discipline them for dishonorable conduct. The 1891 act remedied the problem and compelled all practitioners to submit themselves to the board for a license. Not only did the medical board draft standards; it immediately exercised its statutory authority and began rejecting applicants.

State medical boards throughout the country were adopting similar licensing criteria. Before 1890, only nine states adopted codes of ethics, but during the 1890s, twenty-four more states developed codes of conduct for physicians. These codes governed what grounds could be used by the board either to deny a license or revoke one after issuance. Typically, “the exercise of the same wide discretion cannot be extended to a case where, when one has been regularly admitted, the revocation of his license is sought under another independent provision of the statute.” Like Oregon’s, these codes typically barred unprofessional or dishonorable conduct, procuring abortions, gross immorality, false statements and promises, false advertising, distributing indecent and obscene material, and the fraudulent use of diplomas. Several of these criteria were similar to those adopted by the Illinois board in the 1880s.