Henry S. Pritchett, the president of the Carnegie Foundation, approached the AMA and simply offered to take over the entire project. The minutes for the meeting of the AMA's Council on Medical Education held in New York in December of 1908 tell the story:
At one o'clock an informal conference was held with President Pritchett and Mr. Abraham Flexner of the Carnegie Foundation. Mr. Pritchett had already expressed by correspondence the willingness of the Foundation to cooperate with the Council in investigating the medical schools. He now explained that the Foundation was to investigate all the professions: law, medicine, and theology . . .
He agreed with the opinion previously expressed by the members of the Council that while the Foundation would be guided very largely by the Council's investigation, to avoid the usual claims of partiality no more mention should be made in the report of the Council than any other source of information. The report would therefore be, and have the weight of, a disinterested body, which would then be published far and wide. It would do much to develop public opinion.
Here was the classical "philanthropic formula" at work again. Have others pay a major portion of the bill (the AMA had already done most of the work. The total Carnegie investment was only $ 10,000), reap a large bonus from public opinion (isn't it wonderful that these men are taking an interest in upgrading medical education!), and gain an opportunity to control a large and vital sphere of American life.
This is how that control came about.
The Flexner Report, as it was called, was published in 1910. As anticipated, it was "published far and wide," and it did "do much to develop public opinion." The report quite correctly pointed out the inadequacies of medical education at the time. No one could take exception with that. It also proposed a wide range of sweeping changes, most of which were entirely sound. No one could take exception with those, either. The alert researcher will note, however, the recommendations emphatically included the strengthening of courses in pharmacology and the addition of research departments at all "qualified" medical schools.
After Abraham Flexner completed his report, he became one of the three most influential men in American medicine. The other two were his brother, Dr. Simon Flexner of the Rockefeller Institute and Dr. William Welch of Johns Hopkins Medical School and of the Rockefeller Institute. According to Hinsey, these men, acting as "a triumvirate":