CHANGING ECONOMIC-CONDITIONS AND THEIR EFFECTS ON PROFESSIONAL AUTONOMY - AN ANALYSIS OF FAMILY PRACTITIONERS AND ONCOLOGISTS

This study examines the effects of dimensions of the social structure on professional autonomy. Little support exists for arguments suggesti ng professional dominance or professional-bureaucratic confrontation. The study supports a theory of social change that places physicians in their historical, political, and economic context. There are four imp ortant findings. First, the degree of autonomy varies across physician specializations, and the social structure affects the autonomy of fam ily practitioners and oncologists in different ways. Second, the Feder al Drug Administration constrains the responsibility autonomy of both oncologists and family practitioners, and the innovative autonomy of f amily practitioners. Third, bureaucracy either has no effect or enhanc es physicians' autonomy. The fourth, and most consistent, finding demo nstrates that profit-seeking corporations external to the work setting constrain physicians' autonomy. Findings suggest that researchers sho uld give more attention to shifts in the loci of power and the effects of organizations external to the work setting, especially corporation s, on professions.