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Benjamin Franklin Keene, M.D., 1809-1856, First President of the California Medical Association

s the California Medical Association celebrates its 150th anniversary, we know our many successes in advocating in the legislature, in the courts and in policy for access to care for our patients, public health and the overall preservation of the physician-patient relationship have not come easy. There have been, in 150 years, failures too. There is not always consensus of ideas among physician members and nonmembers – ranging on issues from mandatory health insurance and abortion to end-of-life care and Medicare reform. But the medical association lives on, overcomes its internal differences and still manages to make good healthcare policy each year.

The struggles have been evident since the association formed in 1856 and before. The first elected president, Benjamin Franklin Keene, died months after taking office, and the CMA had little activity from 1859 to 1870 when infighting occurred over views on slavery and other issues. The internal conflict will continue today and next year and in the years afterward mostly because the physicians continue to care about one thing in common – their patients, and this leads to disagreement about how to accomplish that end. It's apparent that throughout history and today, that adversity and diversity produces strength.

To understand the paradoxical stories of the California Medical Assn. it is best to know who formed the original Medical Society of the State of California, as it was called, and how it came to be. California has been at the forefront of several advances in health care, including the advent of the second public health department in the nation in 1870 (founded by a CMA founding father and president); the requirement for all public school children to be vaccinated for smallpox in 1879; policies against smoking in public in the past 25 years; and the care of AIDS patients in the 1980s. These advances in health care have their roots in the men, and eventually women, who worked elbow to elbow with miners, ranchers, bankers, carpenters and bakers to settle this state and overcome their personal differences, and hence begin organized medicine here.