1. Arndt, Margarete
  2. Bigelow, Barbara

Article Content

Tim Hoff's suggestion that a view of physicians as "workers" will add to our understanding of the health care system is the topic of this FORUM. Hoff identifies four significant changes that have occurred in the medical profession-the increase in the number of female physicians, the trend toward salaried employment, physicians working in groups, and physicians engaging in alternative careers-and argues that these developments have the potential to alter the role and function of physicians. They also have significant consequences for research and management. Hoff's view is intriguing and generated interest among the reviewers. We have made his article the focal point of the discussion presented here, which includes commentaries we invited from two individuals with different points of view.


Eugene Schneller raises a number of concerns that may result from no longer viewing physicians as professionals. For example, he cautions that the alignment employers aim for between their own goals and workers' goals may work to patients' detriment. Similarly, he is concerned that insufficient attention may be given to the conflict experienced by physicians who enter management. Schneller argues that we should guard against a decline in professional identity.


Eric Williams focuses on the research implications of Hoff's argument. He points out that organizational behavior has played a relatively minor role in health services research, and that a view of physicians as workers would naturally lead to organizational behavior research into how physicians cope with their new working conditions, or how physicians as leaders interact with patients and with others in the organization.


Tim Hoff's replies to both commentaries conclude the FORUM. We thank him, Eugene Schneller, and Eric Williams for their thoughtful exchange and hope that it generates discussion and stimulates research.