Changing Doctor-Patient Relationships and the Rise in Concern for Accountability

The structure of exchange between doctors and patients has changed as a result of population mobility, professionalization, bureaucratization, and specialization, and it is predicted that third party social controls will deprofessionalize the medical profession.

Abstract

Sociologists have predicted that the growth of a professional class would integrate modern industrial society. Yet public distrust of professionals is growing. This paper examines distrust of doctors and the resultant call for accountability of the medical profession. We look at how the structure of exchange between doctors and patients has changed as a result of population mobility, professionalization, bureaucratization, and specialization. Then we contrast the ideology of the medical profession with that of the patients, and conclude that the latter is a growing, countervailing power to the medical profession and rationalizes the exchange relation by specifying the goals and terms of the exchange. We predict that third party social controls will deprofessionalize the medical profession.