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Serf or citizen: physician status and organizational structure.
Physician Exec. 1998 Jul-Aug; 24(4):45-51.PE

Abstract

For more than a decade, dynamic changes in the health care industry have created new organizations for physicians. The major change for physicians has not been the organization itself, but the principles by which it is governed. This fundamental shift is studied with its impact on physicians, by analogy, becoming more like serfs or more like citizens. A review of the general organizational direction and results of non-physician health care organizations is made followed by the statistical trends of physician groups. Historical comparisons of non-health care industries are made with current organizational choices of physicians and physician groups. Observations of physician decisions are made identifying the direction they send physician status along the continuum from serf to citizen. Physicians are unknowingly making decisions regarding the principles by which they will be governed in new organizations. The choices they are making give them less autonomy and less opportunity to make future choices. The seductive invitation to spend less time in administrative matters and more time practicing medicine is a siren's call that will diminish the status of physicians and the autonomy by which medicine is practiced.

Authors+Show Affiliations

Fisher BA
Schools of Public Health & Medicine, Loma Linda University, CA, USA. bfisher@abs.llumc.ed

MeSH

Collective BargainingDecision Making, OrganizationalHealth Care SectorHumansLeadershipOrganizational CultureOrganizational InnovationPhysician ExecutivesPhysiciansPractice ManagementPractice Management, MedicalProfessional AutonomyUnited States

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10186384

Citation

Fisher, B A.. "Serf or Citizen: Physician Status and Organizational Structure." Physician Executive, vol. 24, no. 4, 1998, pp. 45-51.
Fisher BA. Serf or citizen: physician status and organizational structure. Physician Exec. 1998;24(4):45-51.
Fisher, B. A. (1998). Serf or citizen: physician status and organizational structure. Physician Executive, 24(4), 45-51.
Fisher BA. Serf or Citizen: Physician Status and Organizational Structure. Physician Exec. 1998 Jul-Aug;24(4):45-51. PubMed PMID: 10186384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serf or citizen: physician status and organizational structure. A1 - Fisher,B A, PY - 1998/6/6/pubmed PY - 1998/6/6/medline PY - 1998/6/6/entrez SP - 45 EP - 51 JF - Physician executive JO - Physician Exec VL - 24 IS - 4 N2 - For more than a decade, dynamic changes in the health care industry have created new organizations for physicians. The major change for physicians has not been the organization itself, but the principles by which it is governed. This fundamental shift is studied with its impact on physicians, by analogy, becoming more like serfs or more like citizens. A review of the general organizational direction and results of non-physician health care organizations is made followed by the statistical trends of physician groups. Historical comparisons of non-health care industries are made with current organizational choices of physicians and physician groups. Observations of physician decisions are made identifying the direction they send physician status along the continuum from serf to citizen. Physicians are unknowingly making decisions regarding the principles by which they will be governed in new organizations. The choices they are making give them less autonomy and less opportunity to make future choices. The seductive invitation to spend less time in administrative matters and more time practicing medicine is a siren's call that will diminish the status of physicians and the autonomy by which medicine is practiced. SN - 0898-2759 UR - https://www.unboundmedicine.com/medline/citation/10186384/Serf_or_citizen:_physician_status_and_organizational_structure_ DB - PRIME DP - Unbound Medicine ER -