The Rise and Decline of Professional Control
The shift in public attitude toward the medical profession which occurred toward the end of the 1960s is a significant turning point because it constitutes the watershed in thinking regarding the preferred locus of control over the health care system. The preceding chapter argued that the medical profession's fortunes soared during the first half of the twentieth century largely because its occupational outlook fit so well the prevailing value system. The medical profession was given a great deal of autonomy to conduct its affairs and, more importantly for purposes of this discussion, to assume responsibility for the direction in which the health care system would evolve. This was an era when professionalism grounded in scientific expertise was thought to be the ideal form of institutional leadership and control. In other words, an examination of the evolution of the medical profession must take into consideration the larger social context prevailing at that time. Although this may be obvious, it has not prevented many observers of the medical profession from treating it as if it existed in isolation from major events and ideas that govern the society in which the medical care system exists.
The following discussion addresses, first, the timing of the change in public attitude during the late 1960s and early 1970s toward the medical profession and, second, factors that have been mentioned to explain this shift. However, the principal idea conveyed in this chapter concerns the relationship between scholarly analyses and prevailing social thought. (The meaning attached to the latter concept encompasses public attitudes and popular interpretations of current events.) Basically, I contend that the thinking expressed in scholarly works attracts acclaim from members of the scholarly community because it closely approximates more general public sentiments. Accordingly, the highly acclaimed scholarly analyses produced during earlier periods of time must be viewed as