The Industrialization of "Liberal Medicine" in France: A Labor Quality Conventions Approach

IF 0.9 3区 历史学 Q1 HISTORY Historical Social Research-Historische Sozialforschung Pub Date : 2021-01-01 DOI:10.12759/HSR.46.2021.1.85-111
N. Silva
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Abstract

This article seeks to analyze the evolution of the regulation of liberal medicine in France from the theoretical framework of the economics of convention. The recent introduction by the state of multiple management devices aimed at quantifying and evaluating the performance of physicians could be interpreted as a process of rationalization of medical practices. However, we propose to analyze the transformations in the regulation of liberal medicine as the transition from an inspired/domestic convention of healthcare quality to an industrial convention of healthcare quality. What is at stake is not improving the quality of care, but changing the conception of quality. Do doctors treat sick people or illnesses? This induces significant changes not only in the entire healthcare system but also in medical ethics. While the profession has historically been built against the market, it seems that the industrialization of healthcare opens the door to its commodification.
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法国“自由医学”的产业化:劳工素质公约的途径
本文试图从惯例经济学的理论框架出发,分析法国自由医学规制的演变。国家最近引进了多种旨在量化和评价医生业绩的管理设备,这可以解释为医疗实践合理化的过程。然而,我们建议将自由医学监管的转变分析为从启发/国内医疗质量公约到医疗质量工业公约的过渡。关键不在于提高医疗质量,而在于改变质量的概念。医生治疗病人或疾病吗?这不仅引起了整个医疗保健系统的重大变化,而且引起了医学伦理的重大变化。虽然这个行业在历史上一直是与市场背道而驰的,但医疗保健的工业化似乎为其商品化打开了大门。
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