The issues surrounding health care and health care policy are of great concern to
politicians and the public alike. Government efforts in restructuring medicare, the "jewel" of
Canada's social safety net, also affects the medical profession. It has been argued that this once
powerful and dominant profession is experiencing a decline in its powers and authority. Is this
decline inevitable or can the medical profession adapt to government reforms in such way as to
maintain and even strengthen its power base?
This dissertation examines the themes of professional autonomy and professional
resistance. The changing composition, and possibly the decline, of the medical profession's
clinical, economic, and political autonomy, is analyzed through an historical case study of the
British Columbia Medical Association (BCMA). Minutes from the BCMA's Board of Directors
and Executive, along with interviews with doctors active in BCMA politics, and a media review,
are used to generate a portrait of the social forces influencing medical politics in British
Columbia from 1964 to 1993 and of the BCMA's relations with the various provincial
governments of that period.
The negotiating strategies of the BCMA and the decisions behind these strategies are the
focal point for an examination of professional resistance, an area neglected in sociology. The
dissertation looks at the external and internal conflicts that impact on the resistance tactics of the
BCMA and at the various successes and defeats the medical profession experiences in its bid to
maintain professional autonomy.
During the time period under study, government intervention becomes more frequent and
invasive. The BCMA has the least success in protecting the political dimension of professional
autonomy and most success in controlling aspects of clinical autonomy. The vast variety of
resistance strategies at its disposal distinguishes it from labour groups and most other professions.
Forced to accept measures it once fought against, the BCMA's efforts become focused on
ensuring that reform measures are under the control of doctors (rather than government) to the
greatest extent possible. Although the BCMA has lost aspects of professional autonomy, it
remains one of the few professional organizations today that can force compromise from the
state.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:BVAU.2429/6625 |
| Date | 11 1900 |
| Creators | Farough, D. |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Relation | UBC Retrospective Theses Digitization Project [http://www.library.ubc.ca/archives/retro_theses/] |
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