Skip to main content
Log in

How Physicians Lost Out to Managed Care: A Case Study of Accommodation and Resistance in a Medical Community

  • Published:
Journal of Medical Humanities Aims and scope Submit manuscript

Abstract

This paper involves a case study of physicians working in an urban Midwestern region. It raises questions surrounding how physicians adapted to, encouraged and resisted the increasing presence of managed care in their work lives. The patterning of physician accommodation to managed care and the failure of physicians to mount any effective organized resistance in Metro has some important implications for theories about professional dominance and decline.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Budrys, G. (1993). Coping with change: Physicians in prepaid practice.Sociology of Health and Illness, 15, 353–374.

    Google Scholar 

  • Freidson, E. (1985). The changing nature of the medical profession.Medical Care Review, 42, 11–35.

    Google Scholar 

  • Freidson, E. (1989).Medical work in America: Essays on health care. New Haven, Conn: Yale University Press.

    Google Scholar 

  • Hafferty, F. and Wolinksy, F. (1991). Conflicting characterizations of professional dominance. In J. Levy (Ed.),Current research on occupations and professions (pp. 225–249). Greenwich, CT: JAI Press.

    Google Scholar 

  • Hafferty, F. and Light, D. (1995). Professional dynamics and the changing nature of medical work.Journal of Health and Social Behavior (extra issue), 132–153.

  • Haug, M. (1988). A reexamination of the hypothesis of physician deprofessionalization.Milbank Quarterly, 66, 28–56.

    Google Scholar 

  • Light, D. (1991). Commentary: Professionalism as a countervailing power.Journal of Health Politics, Policy and Law, 16, 499–506.

    Google Scholar 

  • Luft, H.S. (1987).Health maintenance organizations: Dimensions of performance. New York: John Wiley and Sons.

    Google Scholar 

  • McKinley, J.B. and Arches, J. (1985). Towards the proletarianization of physicians.International Journal of Health Services, 15, 161–195.

    Google Scholar 

  • Mechanic, D. (1991). Sources of countervailing power in medicine.Journal of Health Politics Policy and Law, 16, 485–498.

    Google Scholar 

  • Montgomery, K. (1992). A prospective look at the specialty of medical management.Work and occupations, 17, 178–198.

    Google Scholar 

  • Relman, A.S. (1991). Shattuck lecture — The health care industry: Where is it taking us?New England Journal of Medicine, 325, 854–859.

    Google Scholar 

  • Schulz, R., Scheckler, W., Girard, C., and Barker, K. (1990). Physician adaptation to health maintenance organizations and implications for management.Health Services Research, 25, 43–64.

    Google Scholar 

  • Starr, P. (1982).The social transformation of American medicine. New York: Basic Books.

    Google Scholar 

  • Stearns, C.A. (1991). Physicians in restraints: HMO gatekeepers and their perceptions of demanding patients.Qualitative Health Research, 1, 326–348.

    Google Scholar 

  • Wholey, D. R., Christianson, J.B., and Sanchez, S.M. (1993). The effect of physician and corporate interests on the formation of health maintenance organizations.American Journal of Sociology, 99, 164–200.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stearns, C.A. How Physicians Lost Out to Managed Care: A Case Study of Accommodation and Resistance in a Medical Community. Journal of Medical Humanities 18, 261–271 (1997). https://doi.org/10.1023/A:1025650105014

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1025650105014

Keywords

Navigation