Co‐optation, Commodification and the Medical Model: Governing Uk Medicine Since 1991

Self‐regulation and autonomy are traditionally treated as distinctive elements of how professions are governed in contrast to other occupations. For medicine, these elements provide a collective medium of governance (through the institutions of professional self‐regulation) and an individual medium (through the practice of 'clinical autonomy'). Both are reinforced by the intellectual dominance of the so‐called 'biomedical model' of health and illness. Analysts generally agree that, in many countries, both self‐regulation and clinical autonomy are under significant challenge. But it is less obvious that, in the UK at least, the biomedical model has effectively been co‐opted for managerial purposes to support the commodification of medical care. Thus ideas that have traditionally been considered as supporting medical dominance have transpired to be a source of weakness for the profession.