By the time of the American Revolution there are only 41 medical practitioners with a college degree in medicine. Americans resist licensing. Attempts to organize medicine are resented as a threat to freedom. For the most part very few hospitals. Pennsylvania Hospital for the poor opens in 1752.
Hospitals are rare in colonial America.
The colonial period's transfer of medicine from Great Britain to the colonies was limited to voluntary migration physicians and healers, medications and instruments, as well as scientific literature. Medical improvisation was common. This left the colonials on their farms and small towns with a pattern of endemic and epidemic disease, which was similar to comparable stable habitats in Europe.