Medical Dominance and Its Role in Australian Health Care
Medical dominance in Australia
Within Australia, medicine has traditionally dominated every facet of health care delivery (Germov, 2002;
Willis, 1989). The professional status that medicine holds in Australia has been gained by means of its historical and political advantages (Germov, 2002;
Willis, 1989). Willis’s (1989) seminal work on medical dominance provides an extensive review of medical relationships and the power that medicine yields.
Historically, in Australia, medicine gained its position of political and economic power through its relationship
ARTICLE IN PRESS
1064 A. Kenny, S. Duckett / Social Science & Medicine 58 (2004) 1059–1073 with the state (Willis, 1989). The state was dependent on medicine for knowledge and skill and in turn, the state supported the rise of medicine to a position of organizational dominance by sanctioning medicine’s control through licensing laws and the regulation of other health professionals. It has been argued that the primary reason for medicine’s dominance in this country is the authority that it has attained ‘to direct and evaluate the work of others without in turn being subject to formal direction and evaluation by them’ (Friedson,
1970, p. 135). The traditional dominance of medicine over health care in Australia has resulted in a situation where doctors are over represented on other health professionals registration boards, health policy advisory boards, hospital boards and funding bodies for research
(Germov, 2002). The advantages that have been achieved have resulted in a situation where medicine occupies a ‘legally or otherwise formally created position, one which entails a monopoly over a set of services and accessories required’ (Friedson, 1970,
p. 127).
Historically in Australia doctors have primarily been associated with conservative politics. It is argued that these political forces ‘favour free enterprise and private health insurance arrangements’ and have supported the
Within Australia, medicine has traditionally dominated every facet of health care delivery (Germov, 2002;
Willis, 1989). The professional status that medicine holds in Australia has been gained by means of its historical and political advantages (Germov, 2002;
Willis, 1989). Willis’s (1989) seminal work on medical dominance provides an extensive review of medical relationships and the power that medicine yields.
Historically, in Australia, medicine gained its position of political and economic power through its relationship
ARTICLE IN PRESS
1064 A. Kenny, S. Duckett / Social Science & Medicine 58 (2004) 1059–1073 with the state (Willis, 1989). The state was dependent on medicine for knowledge and skill and in turn, the state supported the rise of medicine to a position of organizational dominance by sanctioning medicine’s control through licensing laws and the regulation of other health professionals. It has been argued that the primary reason for medicine’s dominance in this country is the authority that it has attained ‘to direct and evaluate the work of others without in turn being subject to formal direction and evaluation by them’ (Friedson,
1970, p. 135). The traditional dominance of medicine over health care in Australia has resulted in a situation where doctors are over represented on other health professionals registration boards, health policy advisory boards, hospital boards and funding bodies for research
(Germov, 2002). The advantages that have been achieved have resulted in a situation where medicine occupies a ‘legally or otherwise formally created position, one which entails a monopoly over a set of services and accessories required’ (Friedson, 1970,
p. 127).
Historically in Australia doctors have primarily been associated with conservative politics. It is argued that these political forces ‘favour free enterprise and private health insurance arrangements’ and have supported the