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Annals of Family Medicine 2:79-83 (2004)
© 2004 Annals of Family Medicine, Inc.
doi: 10.1370/afm.18
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Essay

Health Care Becomes an Industry

Darius A. Rastegar, MD

Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Md

CORRESPONDING AUTHOR: Darius A. Rastegar, MD, Department of Medicine, Johns Hopkins Bayview Medical Center, D2W 4940 Eastern Avenue, Baltimore, MD 21224, drastega{at}jhmi.edu

ABSTRACT

The delivery of health care is in the process of "industrialization" in that it is undergoing changes in the organization of work which mirror those that began in other industries a century ago. This process is characterized by an increasing division of labor, standardization of roles and tasks, the rise of a managerial superstructure, and the degradation (or de-skilling) of work. The consolidation of the health care industry, the fragmentation of physician roles, and the increasing numbers of nonphysician clinicians will likely accelerate this process. Although these changes hold the promise of more efficient and effective health care, physicians should be concerned about the resultant loss of autonomy, disruption of continuity of care, and the potential erosion of professional values.

Key Words: Primary health care • specialism • professional autonomy • continuity of care




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