In recent years, the American health care system has undergone major changes in organization and sponsorship. From the perspectives of Marxian and Weberian theories, the corporate or government sponsored arrangements which have emerged from these institutional changes are expected to reduce participating physicians' professional autonomy (self-control of their own activity) and authority (control of the medical care process). In opposition to this view, recent occupational theory, emphasizing the social power of professions, has argued that despite the transformations underway within health care, physicians can be expected to retain autonomy and authority. / This case-study of a state-sponsored, pediatric primary care project operating in two locations seeks to assess the relative merits of the prevailing theoretical perspectives described above and to investigate the factors which influence physicians' retention or loss of autonomy and authority. Data from interviews with participating pediatricians, nurse/case managers and with administrators at the project and state level are augmented by the responses of pediatricians in other areas of the state to a survey concerning their perceptions of, and willingness to participate in such a project. / The findings indicate that, although the predictions of both classical and recent theories are partly realized, neither has sufficiently recognized the effects of the composition, internal cohesion and local market circumstances of occupational segments within the medical profession on the strategies physicians use to preserve professional control. These characteristics of occupational segments are apparently associated with variations in professional values which underlie individual responses to specific practice arrangements as well as collective actions to influence the practice arrangements in which physicians participate. / Source: Dissertation Abstracts International, Volume: 52-03, Section: A, page: 1101. / Major Professor: Allen W. Imershein. / Thesis (Ph.D.)--The Florida State University, 1991.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_76344 |
| Contributors | Byers, Joseph Burwell., Florida State University |
| Source Sets | Florida State University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | 249 p. |
| Rights | On campus use only. |
| Relation | Dissertation Abstracts International |
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