McDonaldization or Commercial Re-stratification: Corporatization and the multimodal organisation of English doctors

Justin Waring and Simon Bishop

Social Science & Medicine, 2013, vol. 82, issue C, 147-155

Abstract: This paper investigates transitions in the social organisation of medicine found in the extended opportunities for private corporations to own, manage and deliver public healthcare services in the English National Health Service. It follows recent calls to explain the reconstruction of medical work without reducing analysis to either the structures of organisational control or the strategic resistance of doctors. Accordingly, the paper considers how doctors interact, mediate and co-create new organisational environments. Central to our analysis are the variable sources of power that influence whether doctors acquiesce, resist or re-create change. Drawing on ethnographic research carried out between 2006 and 2010 in two Independent Sector Treatment Centres – private providers of public healthcare - the paper shows how doctors' responses to bureaucratic and commercial structures reflect their own structured forms of power, which have variable value within this new commercial environment. These include clinical experience and specialist knowledge, but also social and economic influence. Building on established sociological debates, these divergent sources of power explain how for some doctors the expansion of private healthcare might involve more extreme forms of McDonaldization, while for others it might involve opportunities for Commercial Re-stratification.

Keywords: United Kingdom; Medical profession; Restratification; Commercialisation; Bureaucracy; Private healthcare (search for similar items in EconPapers)
Date: 2013
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (10)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0277953612008465
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:82:y:2013:i:c:p:147-155

Ordering information: This journal article can be ordered from
http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
http://www.elsevier. ... _01_ooc_1&version=01

DOI: 10.1016/j.socscimed.2012.12.023

Access Statistics for this article

Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian

More articles in Social Science & Medicine from Elsevier
Bibliographic data for series maintained by Catherine Liu ().