Journals / Toplum ve Hekim / 2019 / Cilt: 34 - Sayı: 1

How do Health Reforms and Flexible Production Aff ect Physician Autonomy?

SAĞLIK REFORMLARI VE ESNEK ÜRETİM HEKİM ÖZERKLİĞİNİ NASIL ETKİLİYOR?

Pages
5–16
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

With this erosion in physician’s autonomy it becomes almost impossible for physicians to make free and independent decisions in their profession, act independently, to manage the profession autonomously and to keep control of relevant processes.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Flexible production and reforms in health emerging almost as synchronized in the 1980s as ways of maximizing profit for the capitalist class restructured the process of reproduction of labour power in health.
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Key Findings & Data:The present review article seeks to respond to the question how capitalist mode of production with its health reforms following 1980 aff ected physician’s autonomy.
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Conclusion & Impact:With this erosion in physician’s autonomy it becomes almost impossible for physicians to make free and independent decisions in their profession, act independently, to manage the profession autonomously and to keep control of relevant processes.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Flexible production and reforms in health emerging almost as synchronized in the 1980s as ways of maximizing profit for the capitalist class restructured the process of reproduction of labour power in health. The present review article seeks to respond to the question how capitalist mode of production with its health reforms following 1980 aff ected physician’s autonomy. The available literature and studies suggest that starting from the 80’ies clinic, economic, social and political autonomy of physicians is in erosion under the dual eff ect of fl exible production and reforms in health. Physicians state that this erosion is most palpable in clinic autonomy and performance-based remuneration system. With this erosion in physician’s autonomy it becomes almost impossible for physicians to make free and independent decisions in their profession, act independently, to manage the profession autonomously and to keep control of relevant processes.

Özet

1980’li yıllarda sermaye sınıfının kârını maksimize etmek amacıyla hemen hemen eş zamanlı olarak ortaya çıkan, esnek üretim ve sağlık reformları, sağlık emek gücünün emek sürecini yeniden yapılandırmıştır. Bu derleme makalede, kapitalist üretim tarzının 1980 sonrası mevcut sağlık reformlarıyla esnek üretimin hekim özerkliğini nasıl etkilediği sorusuna yanıt verilmesi amaçlanmıştır. Literatürler ve araştırma sonuçları, 1980’li yıllardan itibaren esnek üretim ve sağlık reformlarının ikili etkisine bağlı olarak hekimlerin klinik, ekonomik, sosyal ve politik, özerkliğinin erozyona uğradığını göstermektedir. Hekimler bu erozyonun en fazla klinik özerklikte ve performansa dayalı ücretlendirmede olduğunu belirtmektedir. Hekimlerin özerkliğinin erozyona uğramasıyla, hekimlerin emek sürecinde özgür ve bağımsız karar vermesi, harekete geçmesi, kendi kendini yönetmesi, kontrolü elinde bulundurması ya da inisiyatif kullanması imkânsızlaşır.

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Cite This Article

HAMZAOĞLU, O., ÖZKAN, Ö. (2019). How do Health Reforms and Flexible Production Aff ect Physician Autonomy?. Toplum ve Hekim, Cilt: 34 - Sayı: 1, 5–16. https://ajindex.com/articles/367401

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References (14)

  1. Annandale, E. (1989) Proletarianization or restratification of the medical profession? The case of obstetrics. International Jo-urnal of Health Services, 19(4):611-634.
  2. Barnett, JR., Barnett, P., Kearns, RA. (1998) Declining profes-sional dominance?: Trends in the proletarianisation of primary care in New Zealand. Social Science & Medicine, 46(2):193-207.
  3. Baum, F., Freeman, T., Sanders, D., Labonte, R., Lawless, A., Javanparast, S. (2006) Comprehensive primary health care under neo-liberalism in Australia. Social Science&Medicine, 168:43-52.
  4. Burdi, MD., Baker, LC. (1998) Market level health maintenan-ce organization activity and physician autonomy and satisfac-tion. The American Journal of Managed Care, 3(9):1357-1366.
  5. Consensus Research Group Inc. (2010) REPORT OF FIN-DINGS A Cross-Country Comparative Study of Physician Au-tonomy Conducted for MedLibn October 14, 2010 New York Düsseldorf Beijing. Erişim adresi: www.medlib.ch/./%20 042011MedLibStudyDeck.pdf. Erişim adresi: 25.11.2018
  6. Church, J., Gerlock, A., Smith DL. (2018) Neoliberalism and ac-countability failure in the delivery of services affecting the health of the public. International Journal of Health Services, 48(4):641–662.
  7. Curtin, L. (1982) Autonomy, accountability and nursing practi-ce. Topics in Clinical Nursing, 4(2):7-14.
  8. Elston, MA. (1991) The Politics of Professional Power. In J. Gabe, M. Calnan, & M. Bury (Eds.), The Sociology of The He-alth Service London: Routledge. pp. 58-88.
  9. Exworthy, M., Wilkinson, EK., McColl, A., Moore, M., Rode-rick, P., Smith, H. (2003) The role of performance indicators in changing the autonomy of the general practice profession in the UK. Social Science&Medicine, 56(7):1493-1504.
  10. Ezekiel, JE., Pearson, SD. (2012) Physician autonomy and he-alth care reform. JAMA, 307(4):367-368.
  11. Forsberg, E., Axelsson, R., Arnetz, B. (2001) Effects of perfor-mance-based reimbursement on the professional autonomy and power of physicians and the quality of care. The International Journal of Health Planning&Management, 16(4):297-310.
  12. Funck, E. (2012) Professional archetype change: The effects of restricted professional autonomy. Professions and Professiona-lism, 2(2): 1-18. Erişim adresi: https://journals.hioa.no/index. php/pp/article/download Erişim adresi: 13.05.2018
  13. Göçmen-Baykara, Z., Şahinoğlu, S. (2013) Hemşirelikte özerklik kavramının incelenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 16(3):176-181.
  14. Hall, R. (1968) Professionalization and bureaucratization. Amer