ORGANIZATIONS IN THE
TRANSFORMATION OF HEALTH
CARE AND RESEARCH
Clinical and scientific professionals and health care organizations are central to the social movements that arise in the U.S. health system, and we devote a section of this book to examining the role of these organizations in health-related social movement activity. While addressing issues similar to those raised in other parts of the book, the papers in this section focus specifically on routine professional activities and formal organizations that challenge the dominant values, structures, and practices of the U.S. health system. The role of professionals in social movements is ironic given that as an elite and highly trained workforce, professionals have a vested interest in protecting—and reproducing—existing authority structures (Friedson 1986). Characteristic of the multi-institutional basis for authority within health care, professionals act as a cultural authority central to the reproduction of cultural meaning and classification.
Likewise, health service organizations are a central part of the delivery of care to individuals and play a leading institutional role, particularly since both federal and local governments transfer substantial amounts of money to service providers for their activities. At the same time, the nonprofit missions of many service providers encourage advocacy activity and the mobilization of new institutional claims. In many cases, both health care professionals and organizations use mobilization tactics to improve work practices and insure adherence to quality standards under attack from other interests in the health care sector. Expertise embedded within the professions and organizations provide the established authoritative base from which to challenge other organized actors.
As the authors in this section elaborate, professionals can strategically combine social movement and work roles in order to push for institutional change. These issues are addressed explicitly by Scott Frickel’s examination of how professional networks operate in the environmental health and justice movements and Michael Goldstein’s consideration of professional