From The Conversation by Philippa Marty:
Impersonation of doctors is a modern phenomenon. It grew out of Western medicine’s drive towards professionalism in the 19th century, which ran alongside the explosion of scientific medical research.
Before this, doctors would be trained by an apprentice-type system, and there was little recourse for damages. A person hired a doctor if they could afford it, and if the treatment was poor, or killed the patient, it was a case of caveat emptor – buyer beware.
But as science made medicine more reliable, the title of “doctor” really began to mean something – especially as the fees began to rise. By the end of the 19th century in the British Empire, becoming a doctor was a complex process. It required long university training, an independent income and the right social connections. Legislation backed this up, with medical registration acts controlling who could and couldn’t use medical titles.
Given the present social status and salaries of medical professionals, it’s easy to see why people would aspire to be doctors. And when the road ahead looks too hard and expensive, it may be tempting to take short cuts.