Medicine And Books

Regulating Medical Work

BMJ 1997; 314 doi: (Published 31 May 1997) Cite this as: BMJ 1997;314:1633
  1. Marilynn M Rosenthal, professor and director
  1. Program in Health Policy Studies, University of Michigan in Dearborn, USA

    Judith Alsop, Linda Mulcahy / Open University Press, £45, pp 230 / ISBN 0 335 19404 4

    Monopoly over medical knowledge lies at the heart of any meaningful discussion of professional regulation. And medical uncertainty lies in the deepest recesses of medical knowledge. Without recognition of this, discussions of professional regulation remain incomplete.

    Regulating Medical Work is an impressive attempt to bring together a variety of research on formal and informal regulation of the medical profession and discuss it in the context of social science analysis. The authors review “the web of regulation,” both formal and informal, found in various institutions and organisations with regulatory responsibility. Included are the NHS, General Medical Council, health service commissioner, the courts, the complaints procedures, and informal collegial efforts. The authors pose various conceptual models of state, institutional, and collegial behaviour as well as providing a summary of the current empirical research, where it exists.

    The authors recognise the importance of the monopoly of medical knowledge and medical uncertainty. In their concluding observations they point out that, despite the increase in regulation across the agencies and organisations discussed, medical knowledge is “unique” and the profession remains in the dominant position to decide what constitutes appropriate medical practice …

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