The professional dominance perspective, revisited

The autonomy of the medical profession, exemplified by its ability to direct the substance of its own work, is a central tenet of Freidson's professional dominance perspective. Critics of professional dominance argue that the autonomy of the profession has eroded because of the loss of its monopoly over medical knowledge and its diminishing authority over patients (deprofessionalization), or because of its loss of control over key occupational prerogatives (proletarianization). The professional dominance of medicine may, however, be more valuable to the profession's own neglect of its avowed public promise to regulate itself than to external forces resulting from changes in the health care delivery system.