"Concurrent with the emergence of the sectarian, there was an explosion of new medical schools: an estimated four hundred new ones opened during the course of the century. Unlike modern-day medical schools, whose strict admission standards are legendary, the majority of these schools were proprietary. Like modern-day vocational schools, they were open to all who could pay their fees, and precisely because they depended upon fees to survive, they were reluctant to fail anyone who could be counted on to pay tuition regularly. Members of the regular medical profession were therefore caught in a dilemma. In order to upgrade the profession’s status, they had to upgrade not only the standards of practice but also the education and qualifications of those who wished to practice. However, the prerequisite to such an upgrading-the restriction of the title of “doctor” to only the bet and the best-trained physicians-was difficult to meet because of the lack of licensing laws. Physicians faced the paradox that they could not obtain licensing laws until they were “better” than the competition, but becoming “better” depended on having licensing laws. The way in which physicians solved this problem was to bring them to the center of the abortion debate in America."