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Reflections on modern doctoring.

J D Stoeckle1

  • 1Harvard Medical School.

The Milbank Quarterly
|January 1, 1988
PubMed
Summary

Physicians are experiencing a significant loss of professional autonomy due to changes in healthcare organization, including corporatization and technology adoption. These shifts negatively impact their control over medical practice and the doctor-patient relationship.

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Area of Science:

  • Medical practice management
  • Healthcare organization studies
  • Physician professional autonomy

Background:

  • Contemporary healthcare systems are undergoing rapid organizational changes.
  • Physicians express concerns regarding diminished control over medical practice.
  • These concerns stem from evolving healthcare delivery models.

Purpose of the Study:

  • To examine the impact of healthcare system changes on physician autonomy.
  • To investigate the effects of corporatization, medical technology, and information technology on the medical profession.
  • To understand physician perspectives on altered professional control and practice.

Main Methods:

  • Qualitative analysis of physician concerns and reported experiences.
  • Review of evidence regarding the effects of practice corporatization.
  • Assessment of the influence of medical and information technology on clinical decision-making.

Main Results:

  • Evidence suggests a considerable loss of physician autonomy in modern medical practice.
  • Corporatization, advanced medical technology, and clinical information systems contribute to this decline.
  • Physicians report increased regulatory constraints and reduced income.

Conclusions:

  • The evolving healthcare landscape is eroding physician autonomy and control.
  • Changes in practice organization critically alter the doctor-patient relationship.
  • Interpersonal rewards of the medical profession are diminished by these systemic shifts.

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