During the colonial era, doctors' education was informal. Most were literate, but some who were raised outside of New England were not. A man who wanted to practice medicine did not need any type of certification. Most did have a period of apprenticeship with an established physician, but even this was not a requirement. Up until the late 19th century, very few doctors had a college education.
Medical facilities were unofficial. Most patients were treated in their homes. However, even the smallest towns had poorhouses, where needy people could live and receive limited medical care.
The few hospitals that opened in North America during the colonial period were opened in places like Quebec and New Orleans. Public health was unknown in North America at this time. Towns and cities did not have boards of health except during times of epidemics. Because most places did not have public water or sewer systems, most Americans got their water from pumps and used outhouses until well into the 19th century. There was no trash collection so the streets became a breeding ground for all types of disease.
There were a few attempts to influence public health. For example, when smallpox vaccinations were developed in the 18th century, many small town doctors had groups of people that had to stay quarantined for a few days to make sure they only developed a mild case of smallpox.
Cures may have killed more people than the diseases themselves. The public developed a very skeptical attitude towards regular doctors. In the early 19th century, the do it yourself attitude of many Americans was popular. These people freely gave medical advice, emphasized the participant of the patient in his or her own treatment. However, other "medical treatments" were available also. Probably snake