Out of Absolute Necessity: Collective Entrepreneurship and the Transformation of the American Surgical Instrument Trade
At the turn of the twentieth century, disparate members of the American surgical instrument trade faced a heavy awakening: trade conditions had spoiled substantially in the past fifty years. Manufacturers had infested the market with so-called fraudulent devices, worsening credibility struggles with buyers. Bad creditors ran amok, forcing instrument makers to incur excessive losses leading to failure. Additionally, the country’s medical profession successfully organized into the American Medical Association, creating a new hierarchy between old peers. These and other dilemmas were substantially exasperated by the fact that “each man in the business regarded every other man in the business his natural enemy,” stressed tradesman E.H. McClure. Without organizational change, the American surgical instrument trade would surely give way to its European counterpart.
This paper investigates how a subset of surgical instrument makers responded to this moment of introspective crisis. It examines several collaborative episodes, including the creation of the American Surgical Trade Association in 1902 and codes of competition thereafter, to understand how instrument makers pursued survival through cooperation. Moreover, this paper interprets their new and fragile association as a critical linchpin in the early history of the medical device industry. While tradesmen were not yet attached to the terms “device” or “industry,” they forged in this moment national and regional networks on which the subsequent growth of the medical device industry depended.
Historiographically, this paper responds to calls from business historians Pierre-Yves Donzé and Paloma Fernández Pérez to analyze changing business practices to “explain why or how medicine and health have transformed from local services into fast-growing and largely globalised businesses during the last century.” It also adds a case study of trade association formation in the health care sector, drawing on familiar surgical texts and instrument catalogues, as well as neglected trade literature and medical journals.
