Perhaps the most influential leader of the American Medical Association in the mid-20th century, Malcolm C. Todd, MD, had risen to the chair of the AMA’s Council on Health Manpower just as the physician assistant concept was sweeping the country. Once the process of accreditation of physician assistant training programs was securely underway, the AMA turned its attention to the certification of graduates of those programs. In October, 1973, Dr. Todd convened a meeting of a number of medical specialty societies and Federal agencies to assess the feasibility of a “Commission” that would oversee eligibility and standards for an examination that was then under development by the National Board of Medical Examiners. Having reported back to their constituents, fourteen national organizations came together again, under Todd’s leadership, at a meeting in August, 1974, that culminated in the formation of the National Commission on Certification of Physician Assistants.
Malcolm Todd was born in Carlyle, Illinois. He received his undergraduate degree from the University of Illinois, and his medical education at Northwestern University. Entering military service during World War II, Todd became an Army surgical chief in Europe. Following the war, as a consultant to the Navy, he helped to develop a medical care program for military dependents.
Todd moved to Long Beach, CA, where, practicing as a general surgeon, but specializing in gastrointestinal surgery, he became chief of staff at Long Beach Memorial Hospital. Active in civic affairs, he served as president of the Long Beach Area Chamber of Commerce, and chaired the local chapter of the American Red Cross. He was elected president of the Long Beach Medical Association, and then in 1968-69, president of the California Medical Association. Having become aware of the physician assistant concept, it was during his presidency of the CMA that Todd helped to persuade the California Legislature to pass regulatory legislation, permitting PAs to practice in the state — one of the first such efforts in the nation.
Beginning in the 1950’s, Todd was a personal physician to Richard M. Nixon for more than two decades, traveling with the Senator as he pursued the Presidency in 1960. That began a career of national public service.
Although opposed to single-payer national health care, Dr. Todd was a strong advocate of universal health insurance through private insurers, using Federal and state programs to fill the gaps for the poor and the elderly. He told the Los Angeles Times that, “No one should be put into bankruptcy because of illness.” He became an advisor to Presidents Kennedy and Johnson, and was credited as one of the “fathers” of Medicare and Medicaid.
When Nixon became President in 1968, Dr. Todd was appointed to three consecutive terms as U.S. delegate to the World Health Organization, and to the Board of Regents of the Uniformed Services University of Health Sciences in Bethesda, MD.
Elected to the American Medical Association Board of Trustees, Todd served as president of the AMA in 1974-75. While in that office he spoke out strongly about spiraling health costs. He exhorted physicians to consider carefully their role in controlling expenditures. He chastised local and state medical societies and state regulatory agencies for their failure to root out incompetent and unethical physicians — a stance that led to substantial reform by the Federation of State Medical Boards. President Gerald Ford named him to the Presidential Economic Commission. Finally, in later years he served as president of the International College of Surgeons and as an advisor to his “fifth President,” Ronald Reagan.
A strong supporter of physician assistants throughout his years at the American Medical Association, it is an irony that it was on the day that Todd achieved his objective of creating the NCCPA, August 8, 1974, that his longtime patient, Richard Nixon, announced his intention to resign the Presidency.
In retirement Malcolm Todd founded the MemorialCare Todd Cancer Institute at Long Beach Memorial Hospital. Dr. Todd passed away in October of 2000, leaving a legacy of institutional and conceptual achievements.
Acknowledgments:This biography was written by Thomas E. Piemme, MD, and was submitted to the Society in August, 2012.