Governing Medicine: Medical Autonomy in the United Kingdom and the Restratification Thesis

This paper outlines the development of the sociological study of medical autonomy and how recent reforms in medical regulation in the United Kingdom illustrate how medical elites are proactively introducing formal performance surveillance and appraisal mechanisms and processes within medical training as they respond to challenges to traditional professional self-regulatory privileges, such as greater state, inter-professional and non-medical involvement in the governance of medical expertise. The paper highlights how such developments reinforce that social scientists have paid too little attention to the restratification thesis when analyzing an apparent decline in medical autonomy. It concludes by arguing for the need to conduct further empirical research into doctor’s educational and clinical freedoms, while also noting the importance of paying close attention to broader changes in how ‘good governance’ is conceptualized and practiced within modern liberal democracies.