Abstract
This chapter continues to focus on the development of the sociological study of the professions and professional regulation as initially outlined in Chap. 4. Leading on from the critique of the neo-Marxist perspective outlined in Chap. 4, this chapter begins by discussing the contribution of Foucault and the governmentality perspective to the study of the professions and professional regulation. Here, the chapter highlights how the governmentality perspective reinforces the need to place analysis of reforms in medical regulation, as well as professional regulation more generally, against the broader background of shifts in how good government is conceptualised and practised within neo-liberal western nation-states. In doing so, this chapter notes how the emergence of calls for more transparent and accountable performance management systems in relation to professional regulation is bound up with the emergence of the risk saturated conditions associated with the risk society. Consequently, rather than seeing a whole-scale decline in medical autonomy, it is argued we are instead seeing a slight compression of its borders alongside a shift in the conditions under which it can be practised, with the result that its enactment becomes a more contested exercise in performance management, particularly when medical error occurs. Here, the chapter notes the similarities between the governmentality and neo-Weberian perspectives via analysis of the literature surrounding the question of if medical autonomy is in decline. In doing so, this chapter introduces the restratification thesis and discusses how rank-and-file practitioners appear to be coming under greater surveillance and control from elite peers as they seek to maintain the principle of professional self-regulation in the face of calls from patient and managers for increased medical transparency and accountability. This sets the scene for exploration of the impact of the restratification thesis on professional practice via analysis of revalidation in Chap. 6 and the handling of fitness to practise cases in Chap. 7. 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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Chamberlain, J.M. (2012). Sociological Deconstructions II: Governmentality and Restratification. In: The Sociology of Medical Regulation. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4896-5_5
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