The Professionalization of General Practitioners with a Special Interest: Rationalization, Restratification and Governmentality

This article critically examines the professionalization of General Practitioners with Special Interests (GPSIs) in the UK. Drawing on empirical research it examines the rationale for the establishment of this professional grouping; the construction of the field of expertise; the negotiation of boundaries with other professions; issues of professional control and autonomy; and internal organization. It concludes that the professionalization of GPSIs is leading to a restratification within the UK medical profession, which continues the Department of Health-led shift in the balance of power from secondary to primary care. This restratification, which enhances GPSIs' work satisfaction, status and in some cases remuneration, is heavily intertwined with managerial and bureaucratic accountabilities, advancing the `reprofessionalization' of medicine and continuing the shift in the boundaries between political and professional jurisdictions. It is posited that this trend is confined neither to one profession nor to the UK.