Physicians occupy a precarious position within the health care system. More informed consumers and the emergence of complementary and alternative medicines (CAM) have eroded trust in the medical profession.

In the 1950s, the role of self-interest constituted the basic distinction between the professional and business worlds. Medical institutions compelled physicians to serve patient welfare, and businesses pursued profit. As medical care has become increasingly commercialized, the altruistic tendencies of the medical profession have been threatened. There is widespread skepticism about the ability of physicians to choose an effective treatment over a profitable one.

This article, from a retrospective issue of the Journal of Health and Social Behavior, explains how sociologists conceptualize the medical profession. The authors emphasize the conflict between self-interest and the physician’s duty to care for their patient. The three main topics are: patient consumerism and trust; the role of evidence in medical decision-making; and the pharmaceutical industry as an intermediary between patient and physician.

Key Findings:

• Patient consumerism, which exploded in the 1960s, helped form the patient-provider relationship, replacing the more paternalistic model in which authority rested with physicians.
• Variations in clinical practice necessitated the development of evidence-based medicine and the use of guidelines for diagnosing and treating patients.
• Many people are using complementary and alternative medicines, such as yoga and herbal medicine, instead of traditional health services.

This article assesses the state of the medical profession. The authors draw several conclusions: physicians are still crucial to the health system; physicians’ influence is limited; researchers must be even-handed in their criticism of the medical profession; and the consequences of health reform are uncertain.