Presentation on theme: "DEPROFESSIONALIZATION OF MEDICINE"— Presentation transcript:
1 DEPROFESSIONALIZATION OF MEDICINE James G. Anderson, Ph.D.Department of Sociology and Anthropology
2 Factors Affecting the profession of Medicine Private health insurance l945-l960Medicare/Medicaid l965HMO Act 1973FTC antitrust ruling l979Monetarization of health careRise in for-profit medical enterprisesIncreased enrollment in managed care plans
5 Rationalization/Restructuring of Health Care Organizations Horizontal IntegrationVertical IntegrationCost ControlsEconomic CredentialingGate KeepersPrior Approval of ServicesPractice profilesIncentivesSubstitution of Allied Health
10 Commercial Medicine: Potential Hazards Diversion of FundsPricingRisk AvoidanceIncreased Load on Public ProvidersDowngrading of PersonnelLoss of Free Speech
11 Commercial Medicine: Potential Hazards Distortions of Clinical Care and Ethical DilemmasManaged CareCommercial Insurance in the Nonprofit SectorPhysicians as EntrepreneursNeglect of Community ResponsibilityMonopoly
12 Social Consequences Physician Employees/Subcontractors Conflicts of InterestDecline in Access to CareDecline in Quality of CareLoss of Physician AutonomyErosion of the profession of MedicineDispirited Physicians
13 Discussion QuestionsWill fewer US students be attracted to medicine as a career?Will quality of medical students be lower?Will most physicians work as employees for private care corporations on a salary basis?Will routine procedures that physicians perform be taken over by nurse practitioners and allied health care workers?
14 Discussion QuestionsAre physicians likely to be subjected to more stringent cost containment efforts?Will doctors join unions?How will these changes effect doctor-patient relations?Will there be increased competition for patients by health care organizations and groups of physicians?
15 Discussion QuestionsHow will these changes affect the ability of professional medical organizations to represent and lobby for physicians?Will increased corporate control and consolidation of health care reduce the autonomy and influence of community boards and local groups of physicians?