The dark side of deprofessionalization of healthcare and
physicians, specifically, is the introduction of consumerism to the
industry, e.g., the focus on customer satisfaction and the pressure
doctors feel to provide services that they might not otherwise
recommend to an adamant patient. Physicians understand that their
reimbursement is partly determined by the satisfaction of their patients
(customers). However insidious, consumerism has not negated the need
for highly qualified physicians from the world of healthcare because
professional values are attached to technical competencies, standards,
and unique responsibilities embedded in the profession itself (Bhugra,
2013). “Professionalism is about mastery of a complex body of
knowledge, competence, integrity, altruism, self-regulation, keeping up
to date with knowledge and promotion of public good (Bhugra, 2013).”
However, as patients have technology that has provided greater access
to information and patients are generally better informed, the cultural
authority of medicine has declined.+ That perception is exacerbated by
the increasingly large intrusion of governments into the healthcare
system, though some argue that state involvement in health care
crystallized medical power +(Coburn, 2001). Either way, the consensus is
that medical power is not what it once was (Coburn, 2001).
Coburn (2001) suggested that the notion of professionalization as
a strategy of control over a particular work domain, which includes as a
key component professional autonomy and self-regulation, implies
continual struggles over such control. The rise of managed care, for
example, threatens physicians’ power structure. In some cases,
physicians must get authorization from an insurance company before
performing tests or referring for x-rays or other types of diagnostic
imaging.+ Physicians and the medical profession no longer have all the
power to define the health agenda for individual patients and the
broader society. Additionally, as nurse practitioners and physician
assistants (originally intended to extend physician services to help close
health care access gaps in rural areas) are being asked to practice at
the top of their license, the ongoing expansion of responsibilities is
renewing opposition from physician groups +(Cheney, 2019). Cheney
(2019) reported that advocates of loosening restrictions on physician
assistants and nurse practitioners claim the proposed reforms to the
scope of practice, supervision, and delegation authority can boost
productivity, lower cost of care, and improve access to healthcare
services. However, there is pushback from physician groups who
express concern for patient safety, citing that the education differential
between physicians and non-physician practitioners has important
implications for how care is delivered (Cheney, 2019). That belief seems
to be supported by research.+ Leach, et al. (2018) found that a slight
majority (55%) of study participants indicated that they prefer
physicians over non-physician providers because of their technical
expertise. So, while physicians struggle to maintain a dominant position
in the health care arena, they remain relevant as part of a
multidisciplinary care team.
References
Bhugra, D. (2013). Demoralization, de-professionalization, denial, and
detachment in medicine?+Australian & New Zealand Journal of
Psychiatry, 47(12), 1104-1107.
doi:https://doi.org/10.1177/0004867413506755
Cheney, C. (2019, February 27).+Why physician assistants and nurse
practitioners need supervision, say, physician groups. Retrieved
March 6, 2022, from Health Leaders Media:
https://www.healthleadersmedia.com/clinical-care/why-physician-
assistants-and-nurse-practitioners-need-supervision-say-physician-
groups
Coburn, D. (2001).+The Medical Profession.+(N. Smelser, & P. Baltes,
Eds.) Permagon: International Encyclopedia of the Social &
Behavioral Sciences. doi:https://doi.org/10.1016/B0-08-043076-
7/03917-6
Leach, B., Gradison, M., Morgan, P., Everett, C., Dill, M., & Olivera, J. S.
(2018, March). Patient preference in primary care provider
type.+Healthcare, 6(1), 13-16. doi:10.1016/j.hjdsi.2017.01.001
