ABSTRACT
In analysing medicine in the NHS, medical sociologists have typically focused on conventional debates about the proletarianization1 and deprofessionalization2 of health professionals via managerialism of the capitalist state and consumerism, respectively (Elston 1991). A key concern is the impact of those processes on medical dominance and doctors’ clinical autonomy. Yet those discussions are limited to the interactions between the medical profession, patients and NHS managers (Annandale 1998: 223-50; Britten 2001). The wider context that shapes or challenges medical dominance needs to be scrutinized by going beyond the terms of these traditional debates to include the roles of the pharmaceutical industry, the state, the courts, and the media (Gabe and Bury 1996). In this chapter, I hope to demonstrate why medical sociology should break into fresh and exciting areas of theoretical synthesis and empirical enquiry by diversifying away from fixation on medical dominance to consider the relationships between the pharmaceutical industry, state agencies and patient organizations. This is important because such relationships can significantly affect NHS patients and professionals.
