ABSTRACT
In the early sociological literature on the professions, doctors were portrayed as solo fee-for-service practitioners (see, for instance, Parsons 1951). This picture corresponds to that of contemporary health care delivery, which has, however, been transformed in most Western countries into a corporate or public primary-care system and a highly specialized and technology-intensive hospital system. During the past decade, this structural change in health care delivery has been the focus of a debate waged in the study of the professions. At issue has been the consequences of this change for the doctors who increasingly are practising in bureaucratic settings. Quite different views have been put forward. Some have advanced a proletarianization thesis of the gradual loss of control over work and autonomy of the medical profession as it becomes the subject of the aims and control of external corporate interests in health care (McKinlay and Arches 1985; McKinlay and Stoeckle 1988; see also Murphy 1990). Others have proposed a restratification thesis that the medical profession will be able to maintain its professional power and autonomy because it has developed an internal differentiation to counter the threats to its dominance in the medical division of labour (Freidson 1984, 1985; Ritzer and Nakzak 1988).
