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This dissertation examines the rise of physician-patient privilege in the United States. Owing to the Duchess of Kingston’s 1776 trial for bigamy, the privilege is not recognized in many common law jurisdictions, including federal courtrooms. Beginning in New York in 1828, however, physician-patient privilege was gradually incorporated into the statutory codes of numerous states. At present, most American courtrooms observe some form of the privilege. Drawing upon medical and legal sources, especially professional journals, this dissertation places physician-patient privilege in its historical context, analyzing the ways in which developments within the medical and legal professions have shaped the evolution of the privilege. Understanding this history is essential in order to explain the history of privilege as policy—that is how physician-patient privilege became a widely accepted legal doctrine in the United States, why the privilege remains such an unevenly applied rule in American courts, and how law protects medical confidentiality today. But it is also sheds light on the intersections of two of America’s most powerful professions—medicine and the law—and carries implications to the broader history of professionalization.