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Doctors, Patients, Managers and the State

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The Sociology of Medical Regulation

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Abstract

This chapter outlines developments in medical regulation as a result of the emergence of biomedicine. It discusses how the shift to hospital medicine led to the institutionalisation of medical autonomy and the principle of self-regulation in the form of the General Medical Council through the 1858 Medical Act. This chapter outlines key developments in medical regulation, tracing as it does so both the golden age of medical power in the first half of the twentieth century as well as how from the 1960s onwards medicine increasingly came under pressure from patient’s rights and consumer movements as well as the rise of hospital management and a growing state concern with efficiency and risk containment. In doing so, this chapter notes how both these external pressures for reform utilised a growing routinisation and standardisations of medical work, via the emergence of evidence-based medicine and the clinical protocol, as a mechanism from which to place medical practitioners under greater third-party managerial surveillance and control as well as to promote patient choice. This state of affairs occurred against the background of the contemporary risk-adverse governing conditions discussed in Chap. 2. This chapter outlines current developments in medical regulation, notably the introduction of revalidation as well as changes in how fitness to practise cases are managed. This chapter concludes by highlighting both the limitations of contemporary surveillance and control of medical expertise as well as how the profession/state relationship requires further attention. This sets the scene for discussion in Chaps. 4 and 5 of sociological perspectives which are concerned with analysing medical regulation. End-of-chapter self-study tasks are provided so the reader can engage in further study in relation to chapter contents.

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Authors and Affiliations

  1. Department of Social Science, University of Loughborough, Loughborough, Leicestershire, UK

    John Martyn Chamberlain

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  1. John Martyn Chamberlain
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© 2012 Springer Science+Business Media Dordrecht

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Chamberlain, J.M. (2012). Doctors, Patients, Managers and the State. In: The Sociology of Medical Regulation. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4896-5_3

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