De professionalization of medicine
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De-Professionalization of Medicine. Leonardi A. Goenawan Interactive Lecture. A Profession under threat. De-professionalization is characterized by the transformation of physicians into persons of self-interest, unionized employees, entrepreneurs and business managers

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De-Professionalization of Medicine

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De-Professionalizationof Medicine

Leonardi A. Goenawan

Interactive Lecture


A Profession under threat

  • De-professionalization is characterized by the transformation of physicians into persons of self-interest, unionized employees, entrepreneurs and business managers

  • A loss of the dedication to service, competence, caring and altruism that has characterized physicians from the beginning

  • An erosion of trust by society


Social Consequences

  • Physician Employees/Subcontractors

  • Conflicts of Interest

  • Decline in Access to Care

  • Decline in Quality of Care

  • Loss of Physician Autonomy

  • Erosion of the profession of Medicine

  • Dispirited Physicians


6 Elements

Unionization of the Medical Profession

Bureaucratization and Politics

Commoditization and Commercialization

Failures of Self-regulation (autonomy)

Choices of Life-style

Modern Medical Education


1. Unionization

Market-driven policies that compromise the quality of care and negatively affect physicians' autonomy and personal satisfaction

Collective bargaining

Adversarial relationships and negotiations

Contrasts and deliverables

Withdrawal of service


2. Bureaucratization

Licensing

Insurance plans

Approval of care

Allocation of resources

Acceptance of increased commercial and managerialresponsibility


3. Commoditization & Commercialization

Volume of services becomes the driving force

Medicine as “business”

Advertising


4. Failures of Self-regulation

Competence and quality

Error

Ethics

Distribution and service

Social responsibility


5. Choices of Life-style

The “soft” discipline

Distribution

Gender


6. Modern Medical Education

Lack of curriculum

The “Hidden” curriculum

Lack of assessment


Discussion Questions

  • Will fewer Indonesianstudents be attracted to medicine as a career?

  • Will quality of medical students be lower?

  • Will most physicians work as employees for private care corporations on a salary basis?

  • Will routine procedures that physicians perform be taken over by nurse practitioners and allied health care workers?


Discussion Questions

  • How will these changes effect doctor-patient relations?

  • Will there be increased competition for patients by health care organizations and groups of physicians?

  • Will increased corporate control and consolidation of health care reduce the autonomy and influence of community boards and local groups of physicians?


Thank You


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