As colonial populations grew, concentrated around port cities like Philadelphia, communities began to recognize a growing need for institutional healthcare. Town authorities were responsible for impoverished sick or disabled community members who did not have their own kinship-based networks. To streamline their provision of care, New York established its first ‘Publick Workhouse’ in 1736, and quickly expanded the institution’s Infirmary into a separate building for contagious diseases. In the ensuing decades, many more American towns and cities followed suit. In Philadelphia, Quaker physician Dr. Thomas Bond and a few wealthy benefactors (including Benjamin Franklin) founded the Pennsylvania Hospital in 1751. Like the early charity hospitals in London and Paris, Pennsylvania Hospital set out to provide medical care to the “sick poor” of the city for free or subsidized rates. From these early stages, American institutional healthcare structurally devalued nursing labor and constrained the role of women in healthcare. While female healers in the medical marketplace could set their own rates and exert their judgment, hospital nurses were among the most marginalized women in the community and they worked under strict supervision for wages that barely sustained them.