With advances in medicine and physiology, the professions of barbers and surgeons diverged; by the 19th century barber-surgeons had virtually disappeared, and surgeons were almost invariably qualified doctors who had specialized in surgery.
The development of medical knowledge and physiological understanding led to a clear distinction between the roles of barbers and surgeons, with barber-surgeons becoming largely irrelevant by the 19th century, while surgeons became respected medical specialists in their field.