Reflections on modern doctoring.

Physicians today are concerned that changes in the organization of medical care may greatly reduce their control of the practice of medicine. Evidence of the effects of three of these changes--the rapid corporatization of practice, the increased use of medical technology, and the use of information technology in clinical decision making--suggests that doctors are losing much of the autonomy that previously characterized their profession. Physicians complain not only about regulatory constraints and loss of income, but also about how changes in the health care system have critically altered the doctor/patient relationship and lessened the interpersonal rewards of the profession.