Medical Dominance and Institutional Change in the Delivery of Health Care Services

This paper puts the theory of medical dominance, as it understood as a sociological theory of historical change, into a broader theory of institutional change of the delivery of medical care. The application of medical dominance theory to three institutional contexts (Australia, USA, and Canada) is reviewed. The possibility of progressive institutional change in the delivery of medical care is addressed, as well as the type of technological innovation that might accompany such institutional change. The concept of medical dominance is useful to explain the dominant characteristics supporting the institution of medical practice. However, an explanatory theory of the evolution of health care delivery should be linked to the instrumentally warranted standards for medical care. These standards are then discussed.

Robert KempEmail: