Abstract: Screening for "Impaired Risks": Risk, Medical Examinations, and Hiring at the Pullman Company in the Early Twentieth Century

Nate Holdren


In 1920 the Pullman Company began conducting company-provided medical examinations, with dramatic consequences for who the company was willing to hire. Pullman's medical examinations came in response to three developments: laws on food handling, high rates of employee turnover, and changes in legal liability for workplace injuries. These developments led the company to view employees as posing a risk and to treat medical examinations as a way to manage this risk. Pullman Company records show how officials wrestled with the implications of medical examinations even as they worked to formulate the goals and techniques for conducting the examinations. D. A. Crawford, Pullman's director of safety, believed that employing people with health conditions or disabilities would raise costs for the company. For Crawford, medical examinations were a means "to prevent physical crooks from getting on the employment list." Pullman's medical director, Thomas Crowder, helped devise Pullman's physical examination program but realized that medical examinations resulted in some people being rendered unemployable. "Who hires those rejected?" Crowder wondered. Ultimately, Pullman considered as many as 20 percent of all applicants physically unfit to work.