Unfamiliar tasks, contested jurisdictions: the changing organization field of medical practice in the United States.
This article proposes that Andrew Abbott's approach to the professions in his System of Professions can usefully be adapted to the study of organizational populations in an organization field. The key phenomena to study using this approach are conflicts over the definition of tasks and over the establishment of jurisdiction over these tasks by particular organizational populations. The following article uses this "tasks and jurisdictions " approach to describe the evolution of the field of medical practice in the United States during the era of managed care. Large employers and the federal and state governments have created two new and unfamiliar tasks--controlling costs and improving quality for defined populations of patients--and assigned jurisdiction over them to health plans. However, these tasks are not well understood, and health plan jurisdiction over them is not accepted by the public or by physicians.
Casalino
Lawrence P
LP
Department of Health Studies, University of Chicago, Chicago, IL 60637, USA. casalino@health.bsd.uchicago.edu
D003695:Delivery of Health Care / Q000639:trends*; D006801:Humans; D008511:Medicine / Q000639:trends; D017146:Models, Organizational; D009936:Organizational Innovation; D011361:Professional Competence; D011787:Quality of Health Care; D014481:United States