The end of autonomy? Reflections on the postprofessional physician

Of the many characteristics that classify the practice of medicine as a profession, autonomy plays the most important role. There are currently assaults on the profession's ability to select, train, and license its own practitioners and on the medical knowledge base itself, as well as the standards for applying it. This article examines factors contributing to this reduction in autonomy and reviews potential impacts on the profession, patients, payors, health care organizations, and managers.