Beyond decline: consumerism, managerialism and the need for a new medical professionalism

In the health care occupational sector powerful social changes have been involved in challenging two of its core features: the centrality of professionalism and medical dominance. This article proposes that factors internal to the health care system, such as health care reforms, can be explained by factors associated with large-scale social developments such as neo-liberalism and post-modernity. The most significant of these have been consumerism and managerialism. The impact of both is assessed by relying on theoretical insights and empirical evidence from recent studies in several countries. Finally, the need for a new medical professionalism will be considered as an adaptive response to the challenges coming from social change.