The Restructuring of Medical Profession

Abstract

Since 1990s, healthcare services have suffered far-reaching changes and reforms that have arisen from a global mutation. The most outstanding aspect of this global mutation is the emergence of a new technoproductive model that produces a drastic organizational transformation. The most remarkable indicator is the management explosion that generates a new project and a new governmentality. The restructuring derived from the reforms mentioned above poses difficulties to the public healthcare organizations, emerged from the welfare state, due to the incompatibility between the new Post-Fordist model and some basic elements of the medical professional model. This conflict generates organizational processes characterized by opacity and complexity. The intensive technological change reinforces the leadership of the biomedical industry inside the medical-industrial complex to the detriment of the physicians. The confluence of these changes transforms the nature of medical practice and erodes his professional autonomy in a way that transcends the categories previously stated by the sociology of the professions, “proletarianization” and “deprofessionalisation”. The increase of the medical-industrial complex under the hegemony of the industries is supported on an alleged constant growth and generates doubts on its social and economic sustainability. The medical institution, powered and guided by the technological innovation and transformed into an intensive consumption and production field, generates a very decentralized scope and worldview with respect to the complex collective health problems that also derive from social inequality and social problems in current societies.