Three Trailblazing Female Physicians Led the ACMA in the Late 1800s Into the 1900s By Donald Waters According to the National Institutes of Health female physicians constituted about 5% of the total physician population in the United States in the year 1900, and slightly higher percentages in some large cities. The total percentage actually decreased in the following decades and did not match the numbers of the early 1900s until sometime around 1960. Consequently, the prospects for female physician leadership within the medical profession would appear quite daunting during a period of great advancement in the quality of medical practice. But those odds didn’t stop three remarkable female physicians in Alameda County from rising to leadership positions in the Alameda County Medical Association (the Alameda County Medical Society -ACMA- became the Alameda-Contra Costa Medical Association -ACCMA – in 1950) during that time period. Sarah Shuey, MD (1851 -1922) served as the first female President of the ACMA in 1895 and was thus the first female physician President of any medical society in the U.S. Pauline S. Nusbaumer, MD (1859-1926) served as ACMA Secretary Treasurer starting in 1910 and also served as ACMA President in 1923. Gertrude Moore, MD (1884-1953) served as Secretary-Treasurer from 1927 to 1945 and on numerous committees that produced ground-breaking programs to improve public health and patient care. Each of these physicians carved out a legacy of clinical expertise and leadership qualities that endeared them to their male physician colleagues and left a mark on the East Bay community. This article, derived from ACCMA Archives and public records, hopes to properly illustrate how remarkable these women were. Sarah I. Shuey, MD (1851-1921) According to a memorial published in the January 1922 edition of the California State Journal of Medicine (published by the California Medical Association), Sarah I. Shuey, MD, was …perhaps, the most widely known woman both medically and philanthropically in the East Bay cities. Records indicate that she was no shrinking violet which undoubtedly had the effect of elevating her to leadership positions within her profession and in local community organizations outside of medicine. Doctor Shuey graduated in the first class of the medical school at the University of California in San Francisco in 1876 and is noted to be the first female physician to establish practice in the City of Berkeley. She practiced in association with another distinguished female physician in the community – C. Antoinette Buckel, MD – the first female member of the ACMA (joined in 1878). Doctor Shuey became a member of the ACMA in 1879. In the book A History of the Alameda County Medical Association, written by ACMA historian Milton H. Shutes, MD, it is noted that the ACMA minutes indicate that the election to membership of Doctor Buckel the year before was not unanimous as compared to her male colleagues, and “…some discussion was elicitated.” Doctor Buckel was also addressed in the minutes as “Miss Doctor Buckel,” but the word “Miss” was later struck out. The second female physician elected to membership was referred to as “Mrs.” without reference to her being a doctor, and the third female member was referred to as “Doctoress.” The book notes, however, that when Doctor Shuey was elected to membership as the fourth female member the following year she was more properly named “Dr. Sarah I. Shuey.” Minutes of ACMA meetings through the 1880s and 90s indicate that Doctor Shuey was not shy in expressing her opinion on local medical issues from the time she became a member. Another passage in A History of the Alameda County Medical Association further documents the impression she projected as a strong-willed and outspoken personality, when it describes an incident where a male resident in the vicinity of Doctor Shuey’s medical office is noted as having told a local beggar seeking a pair of pants that he would surely find such clothing in her office. Doctor Shuey was also an active participant in local public health and political issues of the day. She actively supported the establishment of a certification process for sanitary milk and creation of a probation officer, and provided funding in support of those efforts. Additionally, a biographical database maintained by the National American Woman Suffrage Association (NAWSA) states she was an active member of the Equal Suffrage League of San Francisco and was actively involved in the 1911 campaign to give women the right to vote in California. An article published in 2011 by The Berkeley Daily Planet commemorating the 100-year anniversary of women winning that right recognized Doctor Shuey’s involvement: “Sarah Shuey, a pioneering East Bay doctor from Berkeley said at the same time, ‘Why do I believe in suffrage for women? Because I am a human being as well as a woman, and I believe in true democracy, and wish to get into the company of rational human beings before the law…therefore it is inevitable that women should share in the responsibility for the normal development of the race.’” According to the biography by the National American Woman Suffrage Association, Doctor Shuey was born in Adams County, IL on February 24, 1851. The biography goes on to say: “‘Dr. Shuey established herself as the first woman physician in Berkeley’ and was highly successful in this endeavor, building a renowned reputation for herself and her practice.” Her vigorous participation in the deliberations of the ACMA obviously won her the admiration of her male colleagues, who elected her as the first female President of the ACMA in 1895 and by consequence the first female physician to hold that title in any medical association in the U.S. Subsequent to her Presidency, she served on the Milk Commission starting in the early 1900s, up until her death in 1921. During her career she also served as President of the Board of Health for the City of Oakland, and as an attending physician for girls in the Alameda County Detention Home. Following her death in 1921, the ACMA adopted a resolution mourning “…the loss of this most highly esteemed and greatly beloved Sister…” whose “cooperation and fellowship” had “abundantly enriched” the Association. Pauline S. Nusbaumer, MD (1858-1926) Minutes of a meeting of the Alameda County Medical Association held on December 20, 1926, at the Ethel Moore Memorial Building (still standing, next to the Lake Merritt channel in Oakland) chronicle the program honoring Doctor Nusbaumer following her death on December 5th. Distinguished ACMA Past President and the then CMA President Edward W. Ewer, MD, presided over the program. He highlighted Doctor Nusbaumer’s life’s work as an accomplished physician, medical leader, civic leader, and humanitarian. As part of his remarks, he quoted another ACMA Past President who stated of Doctor Nusbaumer: In the fifteen years in which I have known her, I have come to regard her as the greatest single influence in Oakland in the way of unifying the local medical profession and furthering the practice of ethical, scientific medicine. In his closing comments, Doctor Ewer said of Doctor Nusbaumer: “If she had faults, we know them not.” Doctor Nusbaumer was born in 1858 in Mt. Eden, an agricultural area in the East Bay later incorporated into the City of Hayward. In early childhood she moved to a ranch in Pleasanton. She married and after 35 years of age decided she wanted to be a physician, having been encouraged to do so by a close family friend who was a doctor. She obtained the necessary additional education to qualify her for medical school, passed the entrance examination, and entered the Women’s Medical College of Philadelphia in 1896. She graduated in 1900 and returned to Alameda County to establish a General Practice. After a couple years she found herself drawn to the emerging field of laboratory medicine and took special training in clinical pathology. In 1903 she was appointed City Bacteriologist for the City of Oakland and encountered some resistance because she was a woman. During her tenure she gained the respect of her male colleagues for her tireless work ethic and proficiency. And she capably managed significant challenges, including the health issues associated with refugee camps established in Oakland following the earthquake and fire that devastated San Francisco in 1906 and an outbreak of Bubonic Plague the following year. She held this position in the health department until 1916. In 1910 she organized Western Laboratories with two other physician colleagues, the only diagnostic laboratory in Oakland. Her accomplishment was described at that time as “no greater single influence for the advancement of scientific medicine in the East Bay.” She was the first clinical pathologist to practice in Oakland and the first at Samuel Merritt Hospital, serving that department first as its only clinician and then as a consultant from the time of the department’s origin until her death in 1926. She retired from practice in 1918. Throughout her career, Doctor Nusbaumer’s clinical expertise and public health guidance were considered of the highest quality. Doctor Nusbaumer’s medical leadership earned her high regard by her colleagues, who elected her as Secretary-Treasurer of the ACMA in 1910. She was also elected as a Delegate to the California Medical Association. In 1923 she was elected as ACMA President, the second female physician to serve in that position for the ACMA. She resumed the position of Secretary-Treasurer after her year as President and served until her death at the end of 1926. Among her leadership activities at the ACMA, in 1920 she initiated the publication of a monthly “Bulletin” to be distributed to the membership to inform them of the Association’s activities and of local medical concerns. Additionally, programs she initiated during her year as President in 1923 resulted in a marked increase in Association membership. According to a memorial written for her, her civic activities were described as “various and intense.” She served on the Adult Probation Board, the Anti-Tuberculosis Association, the Board of Associated Charities, as a Director of the Soroptimist Club, on the Business and Professional Women’s Club, and on the Oakland Forum. Following her death, the ACMA paid tribute to Doctor Nusbaumer by adopting a resolution expressing great sorrow for her passing and declaring that she “…represented, during a long lifetime, the best in the glorious achievements of medical professional womanhood.” The ACMA also honored her by soliciting funds from the membership to commission a memorial bronze plaque to be placed in the Library of the Ethel Moore Memorial Building, where the ACMA conducted its meetings. Over 90% of the membership contributed to funding the plaque. Gertrude Moore, MD ( 1884-1953 ) Gertrude Moore, MD, literally followed Pauline Nusbaumer’s path to leadership in the ACMA, succeeding her as ACMA Secretary-Treasurer following Doctor Nusbaumer’s untimely death in 1926. Doctor Moore held that position until 1945, participating in every major meeting during which the ACMA established ground-breaking programs to promote community health. She participated and chronicled the ACMA’s creation of the “Part-Pay Program” in 1932 to provide free medical care to low-income patients when the county could no longer provide care to them. For four years afterward she participated in meetings of ACMA and local hospital leaders to create a non-profit health insurance company to provide coverage for hospital care, which came to be known as Blue Cross of California. And she chronicled the numerous committee meetings, Council meetings, and Annual Meetings that ensued leading up to 1945, the momentous year when the ACMA hired its first full-time Executive Secretary – Rollen Waterson – who lead the ACMA’s creation of a formal program guaranteeing “medical care for all, regardless,” and guaranteeing the medical profession’s accountability to the public. And in 1951, just two years before her passing, she participated with other ACCMA leaders in a nationally broadcasted NBC radio program describing the ACCMA’s “Medical Care for All, Regardless,” commitment to the community. In describing the motivation for the Association to create a comprehensive program to fulfill this commitment, Doctor Moore stated to the narrator of the broadcast: Something is wrong. The price tag is becoming the most important thing in medicine. We must do something about it now . When Doctor Moore retired from the position of Secretary-Treasurer in 1945 the ACMA Council showered her with admiration, issuing a proclamation that prolifically described her as: “Able, clear-thinking, untiring, devoted to the service of others…sincere, fearless and outspoken in her beliefs yet open-minded, kindly and tolerant to views of others…fiercely loyal to Medicine and its ideals for universal medical service of high quality available at all times to all economic groups at costs within their ability to pay…loyal, kindly, sympathetic, honorable…” among many other attributes. In an article published in The Bulletin of the ACMA in September 1945, it was stated: No member in the history of our association has contributed more time, work, and intelligence to the ACMA than Dr. Gertrude Moore, our secretary for nearly twenty years. Alameda County medicine is deeply in her debt. Doctor Moore graduated from Oakland College of Medicine in 1907. Specializing in pathology, she joined Doctor Nusbaumer in establishing Western Laboratories in 1910 to set up the first clinical lab in Oakland. She managed that laboratory up until she retired. In her medical career she served as the pathologist for Fabiola Hospital in Oakland up until it closed in 1932, pathologist for the County Institutions Department (the county health system), and for Providence and East Oakland Hospitals in Oakland and Alameda Hospital in the City of Alameda. She also served as pathologist for the Alameda County District Attorney and the Coroner’s office for 41 years, providing clinical analysis and testimony in criminal cases. In addition to her leadership activities at the ACMA she was a founding fellow of the College of American Pathology, served on the California Medical Association’s Cancer Commission and on the board of the California Division of the American Cancer Society. An obituary published in The Bulletin of the ACCMA in 1953 by ACCMA Past President Dorothy Allen described Doctor Moore as follows: On the death of one who has done so much, there is so little one can say, for forty years of doing can never be expressed adequately in words…Doctor Moore leaves us with many memories of her which will last: her fearlessness and forthright expression, her factual, analytical mind, her honesty and the freedom and willingness with which she gave her medical knowledge to all.