The Consequences of Bureaucratization: A Study of the Work Settings of the General Medical Practice Profession

Abstract

The problem with which the thesis is concerned is an examination of the structure of General Medical Practice and the social changes which it is currently assumed to be undergoing. In so doing, the particular focus is to review and evaluate the adequacy of the major theoretical scheme which has been used for conceptualizing these changes. It is hoped furthermore to shed some light on the probable consequences of these changes. The thesis arose out of a larger study on which I was employed. Limited details of the methodology of both the overall study and the thesis are contained in Chapter 2. As the study progressed, my interest focused upon the implications of the different work settings (i.e. the type of practice in which he/she operates) for the General Practitioner (G.P.) and his family. However in utilizing the dominant theoretical approach to the study of the professions, (represented most explicitly, though not by any means exclusively by the monumental works of Talcott Parsons), I came to see ways in which this traditional approach was not fully adequate. This dissatisfaction lead to an examination of the usefulness of this traditional approach, in particular the extent to which it was ideological in nature and the extent to which it was theoretical. The medical profession and especially the General Practice subpart of that, is important to study, it is suggested, for three reasons. Firstly this profession has long been regarded as the arch-typical profession and has been widely used as the traditional basis for conceptualizing the professions and professionalization. (Carr Saunders and Wilson, 1933; Marshall, 1939; Cogan, 1953; Goode, 1957; 1960; Becker, 1962; Lewis and Maude, 1953; Parsons, 1954).