ABSTRACT
This chapter explores how the nature of the medical "commodity" determines, at least in part, the size and how changes in the nature of the commodity affected the chances of success of the professional entrepreneurs who were attempting to unify and control the medical market. The general ideological climate of Western societies has favored the functions medicine claims to serve; the value of individual life, rooted in the Judaeo-Christian religious tradition, and individualism in general, have formed one of the strongest ideological dimensions of the post-feudal world. The "strong" market characteristics of medicine were not sufficient in themselves to ensure monopolistic control. The difference between engineering and medicine is that the physical nature of the engineer's professional product immediately involves the possibility that the buyer be a different person from the consumer. Modem medicine illuminates how functionally rational elements of legitimation— scientific expertise and proved technical superiority in healing— blend with traditional, irrational, or substantively rational supports.
