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Medical technology and professional dominance theory
Social Science & Medicine (1982)
|January 1, 1984
Summary
Physician influence on hospital technology adoption is complex, varying by physician type and hospital decision systems. Understanding these nuances is key to explaining technology expansion in healthcare organizations.
Area of Science:
- Health Services Research
- Medical Sociology
- Organizational Behavior
Background:
- Hospital technology adoption is often attributed to physician preferences and professional dominance.
- Existing theories may oversimplify the complex dynamics of healthcare organizations.
Purpose of the Study:
- To examine the theoretical and empirical basis of professional dominance in explaining hospital technology adoption.
- To analyze how different physician categories and hospital decision systems influence technology adoption.
Main Methods:
- Analysis based on 5 years of data collection.
- 378 personal interviews conducted across 25 U.S. hospitals.
- Identification of four physician categories and three hospital decision systems.
Main Results:
- Physician influence on technology adoption is not monolithic; it depends on specific physician types and hospital decision-making structures.
- Four distinct physician categories (community generalists, community specialists, referral specialists, hospital-based specialists) possess varying influence.
- Three decision systems (medical-individualistic, fiscal-managerial, strategic-institutional) operate with different values and goals.
Conclusions:
- The concept of professional dominance requires refinement to account for physician and hospital heterogeneity.
- Effective analysis of technology adoption necessitates specifying physician roles and the relevant hospital decision systems.
- Physicians with the most apparent dominance resources are involved in only one of the three identified decision systems.