This new volume illuminates the growing corporate in-roads into the health care system and its probable consequences, especially for physicians and other practitioners. Its fourteen contributors examine both the delivery and supply functions in the health sector in America. Ambulatory care, hospitals, health maintenance organizations, and health promotion activities are each critically dissected. A major thrust of the investigations focuses upon implications for the medical profession, principally how the increased scrutiny over clinical decision making by corporate purchasers and payors threatens the traditional role and relative autonomy of physicians. Varying theoretical perspectives are debated, with an additional Canadian perspective offered.

Warren J. Salmon

Preface Victor W. Sidel

ntroduction J. Warren Salmon

PART 1: Background and Current Issues The "Corporatization" of U.S. Hospitals: What Can We Learn from the Nineteenth Century Industrial Experience? William D. White

Walk-In Chains: The Proprietarization of Ambulatory Care Howard S. Berliner and Robb K. Burlage

The Profitization of Health Promotion Nancy Milio

The Corporate Compromise: A Marxist View of Health Maintenance Organizations and Prospective Payment David U. Himmelstein and Steffie Woolhandler

PART 2: Implications for the Medical Profession Reflections on Modern Doctoring John D. Stoeckle

The Futures of Physicians: Agency and Autonomy Reconsidered J. Warren Salmon, William D. White and Joe Feinglass

The Use of Medical Management Information Systems to Increase the Clinical Productivity of Physicians Joe Feinglass and J. Warren Salmon

The Changing Character of the Medical Profession: A Theoretical Overview Donald Light and Sol Levine

Professional Dominance or Proletarianization? Neither Vicente Navarro

The Changing Doctor-Patient Relationship and Performance Monitoring: An Agency Perspective William D. White, J. Warren Salmon and Joe Feinglass

Canadian Medicine: Dominance or Proletarianization? David Coburn

Epilogue Vicente Navarro

Contributors

Index