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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

De-Professionalizationof Medicine

Leonardi A. Goenawan

Interactive Lecture

a profession under threat
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
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
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
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
2. Bureaucratization


Insurance plans

Approval of care

Allocation of resources

Acceptance of increased commercial and managerialresponsibility

3 commoditization commercialization
3. Commoditization & Commercialization

Volume of services becomes the driving force

Medicine as “business”


4 failures of self regulation
4. Failures of Self-regulation

Competence and quality



Distribution and service

Social responsibility

5 choices of life style
5. Choices of Life-style

The “soft” discipline



6 modern medical education
6. Modern Medical Education

Lack of curriculum

The “Hidden” curriculum

Lack of assessment

discussion questions
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 questions1
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?