Persistent power? the weakening of the medical profession's control over knowledge in canada

TLDR: The author reveals that doctors’ resistance to Scope of Practice changes and their reaction to technology have changed since the implementation of the Canada Medicare reforms in 2003.

Abstract: ..........................................................................................................................................iv List of Abbreviations Used..............................................................................................................v Acknowledgements.........................................................................................................................vi Chapter 1: Introduction....................................................................................................................1 Background: Doctors and Canadian Medicare.....................................................................2 Chapter Outline.....................................................................................................................8 Chapter 2: What is Known About Physician Power?....................................................................12 Complaints..........................................................................................................................12 International Literature.......................................................................................................19 The Medical Profession as an Interest Group.....................................................................21 Popularity and Discourse....................................................................................................25 Sociology of the Professions..............................................................................................30 Tuohy and Institutionalism.................................................................................................33 Building on Tuohy’s Framework........................................................................................41 Implications........................................................................................................................46 Chapter 3: Are the Conditions Underlying Physician Power in Canada Changing?.....................50 Doctors and their Government: Reducing the State’s Reliance on Physicians for Information...................................................................................................................51 Doctors and their Patients: Diffusion of Knowledge to the Population.............................59 Doctors and their Coworkers: The Expanding Scope of Practice of Lower-Paid Health Professionals...........................................................................................................68 Chapter 4: How have Doctors Responded?...................................................................................76 Physicians’ Resistance to Scope of Practice Changes........................................................78 Their Acceptance (and Co-optation) of Certain Reforms...................................................84 Their Reaction to Technology.............................................................................................90 Mitigation, not Confrontation: What this Response Means for the Future of Physician Power..................................................................................................................................95 Chapter 5: Conclusion....................................................................................................................98 The Counterargument.......................................................................................................100