| Medical sociologists are fascinated with the work of physicians, to the point of obsession. Sociologically speaking, the rise of physicians from disenfranchised practitioners to the most powerful professional group in the country provides ample intellectual debate and fascination.;The constant tension between the financial business of practicing medicine and the art and altruism of healing is the heart of conflict in 21 st Century medicine. As professionals, physicians find themselves in the middle of a cultural battle over the moral and ethical of question of how financial considerations should weigh in on medical care, if at all. A profound shift in medicine beginning in the 1970's challenged the idea that healing and finance should not mix. Managed care and the corporatization of medicine offered a fix to an out of control health care system. The concept was simple: Instead of forcing financial concerns out of medical care in the interest of protecting patients and the work of physicians, the philosophy of managed care stated that all healthcare delivery could actually benefit if the two were intertwined.;This historical shift is the starting place for my dissertation, which focuses on the daily experiences of physicians as professionals in the often-complicated world of corporate medicine. Through qualitative analysis of interview data and ethnographic observation, I highlight how physicians negotiate individual relationships with each other and other professionals. Specific attention is given to professional age (years of practice), work arrangement and specialty, and how physicians differ in terms of practical, daily experience along these lines, and also how they differ in their theoretical approach to medicine, their professional status and their views on managed care more generally. An additional facet in the work explores how the American Medical Association (AMA) has responded (or failed to respond) to physicians and their rapidly changing professional lives. The works of Abbott, Freidson, Starr and others lay the groundwork for this dissertation. |
