title: Professional autonomy in the health care system.
abstract: Professional autonomy interferes at a structural level with the various aspects of the health care system. The health care systems that can be distinguished all feature a specific design of professional autonomy, but experience their own governance problems. Empirical health care systems in the West are a nationally coloured blend of ideal type health care systems. From a normative perspective, the optimal health care system should consist of elements of all the ideal types. A workable optimum taking national values into account could be attained by governance structures that also introduce elements from other ideal type systems. Thus a normative approach to medical practice guaranteeing an essential degree of professional autonomy for a relationship of trust between the patient and the physician, could be combined with an efficient and equitable allocation of health care resources.
authors.affiliation: Department of Public Health, Erasmus University, Rotterdam, The Netherlands. polder@mgz.fgg.eur.nl
authors.forename: J J
authors.initials: JJ
authors.lastname: Polder
authors.forename: H
authors.initials: H
authors.lastname: Jochemsen
mesh_terms: D003659:Decision Making, Organizational; D003695:Delivery of Health Care / Q000458:organization & administration*; D004992:Ethics, Medical; D015276:Health Care Rationing / Q000458:organization & administration; D006801:Humans; D038622:Internationality; D017146:Models, Organizational; D010819:Physician's Role; D010817:Physician-Patient Relations; D017009:Professional Autonomy; D019366:Western World