American medical doctors in the nineteenth century were not the respected professionals they are today, mainly because their training was so poor. The public had little confidence in their abilities; many people with experience and a few good reference books felt quite as capable as a doctor to assist their families during illness. These people weren’t far off, as many times doctors trained solely by following another physician around and reading a few books.
In his 1904 History of South Dakota, historian Doane Robinson described the difficulties doctors faced in earning a living in this western region: “Up to this time (1865) not a single Dakota doctor had been able to sustain himself solely by his profession,” Robinson wrote. He went on to describe the first law of Dakota which affected physicians. “[It] exempted him from jury duty, but it (at) the same time made him guilty of a misdemeanor if he poisoned a patient while intoxicated, if the life of the patient was endangered thereby, but if the poison killed the patient then the physician was to be deemed guilty of manslaughter in the second degree.”
The 1868-69 legislative session passed another law concerning physicians, which regulated their practice. It was unlawful to practice medicine or surgery for pay, unless the person had first taken “at least two full courses of lectures and instruction and graduated from a medical college.”
This depth of instruction was not beyond a studious layperson’s abilities, so it is not surprising that many families felt they could help themselves rather than pay for a doctor.