Canadian medicine: dominance or proletarianization?

Abstract

Changes in the Canadian health care system since the early 1960s, especially the introduction of national health insurance and increased government control over the cost and utilization of services, have been resisted by the medical profession. The history of the conflicts between the Canadian government and the medical profession over control of the health care system provides evidence that medical dominance has declined. In spite of its loss of power over the organization of health care and medical work, however, the profession is still too powerful to be described as proletarianized. Freidson's theoretical conception of professional dominance provides the best explanation of the position of Canadian physicians, but his argument that power is preserved by having physicians control other physicians fails to take into account the profession's lack of internal cohesion.