Physician autonomy in the Federal Republic of Germany, Great Britain and The United States

Abstract

The concepts of ‘professionalism’ (including autonomy) and ‘management’ (involving the control of others) are logically opposed; but, in the field of health care, physicians and managers have largely co-existed without such opposition. International pressures for cost containment, however, now raise questions about the future nature of physician autonomy. This paper attempts, firstly, to conceptualize the nature of clinical autonomy as a number of independent components; secondly, to describe the nature of such autonomy in three countries in terms of these components; and, thirdly, to identify related questions for future research.