La professione medica nella sanità riformata: alcune categorie concettuali per leggere il mutamento

Abstract

Healthcare has changed a lot during the last decades of the Twentieth century within Western societies: reforms have been implemented to face the increasing challenges of health systems in a context of crisis of the welfare state’s bedrocks. The most important issue of these reforms is the introduction of New Public Management techniques and quasi-market’s principles in public work organizations. This paper is aimed to give some sociological issues conceptualized to read the change involving medical profession within reformed healthcare systems. It focuses on the social context where a need to reform healthcare emerges and it proposes some concepts to interpret the change: managerialism, consumerism and professionalism as logics of work organization, professionalism as occupational and organizational value, reformed healthcare as intersection of two different institutional logics: medical professionalism and business-like healthcare. Afterwards, it is proposed a literature review dealing with professionals/organization relation and researches about doctors’ strategic reactions to marketization process. These studies demonstrate that a reframe of medical profession within health organizations is ongoing, instead of a conflict resulting in a zero sum game between professions and organizations.