Lecture 8 Flashcards
The Profession of Medicine
Goode definition (1960’s)
Three things
Goode (1960) defined a profession as having: autonomy, rigorous standards, and prestige
The Profession of Medicine Professional Dominance (Freidson, 1970)
Occupation has assumed dominant position in a division of labor, so it gains control over the determination of its own work.
The Profession of Medicine
How to become dominant? (2 Ways)
1: Convince the public of valuable work
– Knowledgeable authority on the subject
– Granting of legal autonomy by governing bodies
– Right to be self regulating
2: Control over # and credentials of practitioners + control over other health care workers
Has the profession remained dominant?
De-professionalization: Power decline (Haug)
Four
– Autonomy of work declines, dominion over patients lessened, public lost some confidence, knowledge become more widespread
Has the profession remained dominant?
Proletarianization (McKinlay) Marxist view
– Physicians are workers and not owners: slowly
lose authority
Has the profession remained dominant?
Corporatization: Light and Levine
– Corporate control without Marxist assumptions.
• Concerned with increasing corporate control of medicine
And for Freidson?
Physicians remain the health care experts
Has the profession remained dominant?
Countervailing Powers (Light et al.)
Three
P&P 4
– When one group gains considerable power, other
groups attempt to balance
– Relationship between profession and society is in flux
– Public and private sectors gained back power by: controlling costs, quality of life and cost effectiveness of treatments, issues, lack of technological restraint
Voluntary Associations: Weber (1910)
A voluntary association had two ideal-typical traits reminiscent of ‘the sect’: first, it had qualified people and, second, it rejected sanctions typical of an authoritarian organization (looser set of rules)
Professional Medical Associations
AMA
AMA: set up in 1847: Promote science and art of medicine
– Controlled entrance, training, and practice
Convening Doctor Power
Flexner Report
1904 AMA set up Council on Medical Education
• Pre-med requirements, standard training period, licensing tests.
• Issued a report judged schools: Many of which inferior but, this report was not published
AMA: gave Abraham Flexner task: 1910 issued his report on the best and worst schools
Professional Medical Associations
Women
Elizabeth Blackwell (1849) 1st female physician
Medical Women’s National Association (1915)
Professional Medical Associations
AAs
National Medical Association (1895)
Professional society for African American physicians
Social Control of Medicine
Defined
Defined ability of individuals or groups to regulate themselves (internal) and for others to regulate the individual or group (external)
Social Control of Medicine
Internal
Internal Control: Physicians have autonomy to self-regulate
