SOC355 week10

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School

University of Toronto *

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Course

355

Subject

Medicine

Date

Oct 30, 2023

Type

pdf

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Uploaded by MinisterGorilla6495

AUTONOMY , ETHICS & COMMERCIALISM This Photo by Unknown Author is licensed under CC BY-NC-ND

Drug makers in Canada disclose doctor payments as transparency debate heats up • Ten of Canada’s largest pharmaceutical companies together made nearly $75- million in payments to doctors and health-care organizations last year, according to a voluntary disclosure effort that comes as two provinces prepare to force more transparency on the drug industry. • For the second year in a row, the Canadian branches of 10 brand-name drug companies released aggregate totals without naming doctors or revealing how many they paid to deliver speeches, sit on advisory boards or travel to international medical conferences. https://www.theglobeandmail.com/canada/article-drug-companies-paid-nearly-75-million-to-doctors-health-care/

AUTONOMY, ETHICS & COMMERCIALISM (Timmermans and Oh) • The question: • Has the medical profession’s mandate to take care of clients been undermined by the influx of money into health care? • We examine the medical profession’s transformation over the past decades

AUTONOMY, ETHICS & COMMERCIALISM • Social scientists over the past decades have repeatedly written the obituary of the medical profession with terms such as decline of power, deprofessionalization, and proletarianization • It may, however, be too early to count out the medical profession • One of the most pressing issues in contemporary health policy is the question of whether health care organized through professions offers good value for its money. • What is the role of physicians in the quality, efficiency, and cost of U.S. health care? • The strength of a sociological approach is to provide a bird’s-eye view of the profession in relation to other health care stakeholders.

Medicine as a profession • Compared to other occupations, a distinguishing characteristic of a profession is an implicit social contract between the profession and the state. The profession makes successful claims for specialized and valued skills meriting legal protection provided by the state. • In return for a state-sanctioned economic market shelter and legal privileges of training and certifying new members, the profession is expected to focus on the needs of its clients using scientifically validated knowledge. https://www.ontario.ca/laws/statute/91m30

A third logic • A profession is thus, as Freidson (2001) put it, a third logic distinct from the logic of the market and bureaucracy. • If professions were working as bureaucratic occupations (the first logic), professionals would lose control over their work and be technicians. • Yet, if professionals were exposed to the open competition of the market (the second logic), one would expect that they would be driven by maximizing profit against competitors. • The professional logic rests upon the promise of providing complex and esoteric scientifically-supported knowledge to clients in exchange for state protections. Professions are legally protected against competitors—one can be prosecuted for practicing medicine without a license. • In return, professionals should put their clients’ interests above their own financial and bureaucratic interests.

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