title: From service to commodity: corporization, competition, commodification, and customer culture transforms health care.
abstract: Corporate medical practice, a market economy, and a consumer culture are transforming health care. The service relationships of doctors with patients are now commodities. The doctor, directed by disease management protocols (to improve outcomes, reduce costs, and standardize care), is, in effect, providing programmed service commodities. In addition, medical-surgical specialties, now "packaged" for the care of body parts and conditions (as Breast, Stroke, Obesity, Aneurysm Centers), are also made service commodities, marketed by newspaper advertisements, TV, radio, and Internet to patient-customers in search of a healthy body. In sum, the promise of corporate practice in a competitive market economy is greater efficiency and productivity to reduce the costs of care that are a burden on industries and the state. Viewed from office encounters with patients, such transformation of services to commodities changes the doctor-patient relationship and the moral mission of care.
authors.affiliation: Primary Care, Massachusetts General Hospital, Boston, MA 02114, USA, lpaciulan@partners.org
authors.forename: J D
authors.initials: JD
authors.lastname: Stoeckle
mesh_terms: D004465:Economic Competition; D019981:Health Care Sector / Q000639:trends*; D015279:Organizational Culture; D010817:Physician-Patient Relations; D011362:Professional Corporations; D014481:United States