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Over the last half century, changes in the structure of medicine have shifted the relationship between the profession of medicine and social institutions. In this paper, I uncover ideas for retheorizing this relationship by analyzing a review by Georg Simmel that has been previously overlooked. In an analytical overview and critical appraisal of Simmel's text, I argue that he considered preventative medical knowledge more influential when this knowledge is located outside the physician-patient relationship. Simmel suggests we need to identify how such knowledge is injected into medical and non-medical settings by the mixtures of professional-, market-, and state-based institutions governing medicine, and pay attention to how these institutions shift. His goals show continuity with a social medicine movement in Germany previously thought to be stalled, and are unique too in their focus on targeting institutions over individuals. Through a close analysis of Simmel's ideas, we can see the relationship of public health with social structural studies of medicine in theoretically innovative ways., (Copyright © 2014 Elsevier Ltd. All rights reserved.)