This thesis examines several recent transformations in the United States health care
system and their effects on the role of physicians. Technology, specialization, ancillary
health care workers, for-profit hospitals and managed care corporations have all expanded
throughout the health care industry. These changes have resulted in an increase in
bureaucratic, capitalist and corporate influences over the system. As a result of the
increasing costs of medical practice, the corporatization of health care is occurring in
which physicians must not only rely on corporations for access to the capital that they
need, but also relinquish some of their power to the corporations. McKinlay and Arches
(1985) assert that these changes have led to the proletarianization of the physician. Health
maintenance organizations (HMOs) and other forms of managed care companies continue
to grow throughout the United States. Therefore, physicians, who have historically
dominated the health care system, no longer have the autonomy that they once had. To
measure physicians' attitudes toward these changes, The Managed Care in the New River
Valley survey was conducted. The findings show that although managed care is not as
strong as it is in other parts of the country, physicians still believe that their control of
health care is declining. The importance of managed care companies and other third party influences will continue to increase in the future, as they further extend to areas such as
the New River Valley.
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