The corporatization of health care in the New River Valley, Virginia

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.