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The End of the Golden Age of Doctoring

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Tatiana Lopez

on 27 September 2016

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Transcript of The End of the Golden Age of Doctoring

The decline of the medical profession and professionalism
Extrinsic and intrinsic factors
Beureaucratization of Doctoring
Competition
the traditional disciplines
the alternative or complementary providers
specialty disciplines
Globalization and the information revolution
“it is the very dynamic of globalization that its dimensions operate
both at the global and local level at the same time”
Policies promulgated by supranational organizations and agreements between governments are marginalizing once powerful national and local professional associations, limiting their ability to control licensure and training and shape legislation so as to benefit their constituency.

Extrinsic Factors:
shifting allegiance of the state
Beureaucratization of Doctoring
Competition
Globalization and the information revolution
The epidemiologic transtion and changing concepts of the body
Erosion of doctor patient relationship

Shifting allegiance of the state
The End of the Golden Age of Doctoring
Intrinsic Factors

weakening of market position through oversupply
doctors union
The epidemiologic transtion and changing concepts of the body
Erosion of doctor patient relationship
Intrinsic Factors
weakening of market position through oversupply
Doctors Union
John B. MicKinlay and Lisa D. Marceau
employees
physician’s in self-employed solo practices
self-employed group practices
assembly line medicine
The recent rapid increase in the number of physicians and other health workers is already creating intradisciplinary (between physicians) and interdisciplinary (between physician and nonphysician clinicians) rivalries.
The age of pestilence and
famine
The age of receding
pandemics
The age of degenerative and human-made
diseases
The age of delayed degenerative diseases.
The age of globalized health threats
A measure of the change in this
relationship lies in the words now used to describe it: “doctor” becomes
“provider,” “patient” becomes “client,” and “relationship”is an
“encounter.”
physician surplus

One commentator thinks that a decrease of 25,000 physicians
(40 percent) and 16,000 residents (40 percent) is necessary to bring this region
to the national norm: “it is unlikely that in the near term this region could
absorb more physicians per capita than now exist”
AMA
National legislation
specialty-based societies (unions) replaced the increasingly distant AMA as the primary reference group of many physicians.
describe the historic magnitude of the changes in the financing and organization of U.S. medical care and their implications for professionalism, the social position of doctors, and the everyday work of doctoring.

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