A re-examination of the hypothesis of physician deprofessionalization

If professions are characterized by their monopolization of esoteric knowledge, autonomy in work performance, and authority over clients, then "deprofessionalization" is measured by the degree to which these characteristics are diminished or lacking for the members of a profession. Physicians' monopoly of knowledge has been recently challenged by computer technology and the public's rising educational level; their authority has eroded as patients adopt a more questioning attitude toward medicine; and their autonomy has lessened with the growth of group practices, peer review and cost-containment measures. Current evidence is insufficient either to retain or reject the physician deprofessionalization hypothesis; more time is needed before the erosion of medicine's authority can be assessed.