JAMA · 1970 · 254 citations · 0 references
Social SciencesSociologyClinical MedicineMedical SociologySocial MedicinePhysician-patient RelationshipPractice OrganizationMedical Professional OrganizationsOrganizational Service OrientationPhysician PowerProfessional Authority
Freidson argues that the medical profession has become overly autonomous and powerful, warranting regulatory oversight. He constructs his critique through a comprehensive theoretical analysis, beginning with the profession’s formal organization and extending to the organization and regulation of its work. He concludes that clinical knowledge is not esoteric, physicians are action‑oriented and pragmatic, and their service orientation is too weak to justify autonomous professional claims.
Buried in the pedantic pages of this book is a pointed challenge to medicine. Simply stated, Freidson's view is that the medical profession has become too autonomous and too powerful for the good of society, and that it must therefore be regulated. Like the prominent medical sociologist he is, the author develops his argument through an exhaustive theoretical analysis. He begins with the formal organization of the profession and proceeds to the ways in which the performance of its work is organized and regulated. He denies that the knowledge required for clinical practice is so esoteric that it cannot be questioned by lay persons. The "clinical mentality" he finds to be characterized by action orientation and pragmatism. Physicians, he concedes, do have a service orientation as well, but he believes it to be not prominent and not a sufficient basis for claims to professional autonomy. Physicians expect to be allowed