DOCTORING MEDICAL GOVERNANCE: MEDICAL SELF-REGULATION IN TRANSITION -- CONTENTS -- PREFACE -- DEDICATION -- INTRODUCTION -- FROM ANCIENT BEGINNINGS TO THE 1858 MEDICAL ACT -- Ancient Beginnings -- Galen's Humors -- Galenic Medicine and the Christian Worldview -- The Enlightenment and the Clinical Gaze of the Biomedical Model -- Medicine in the Eighteenth Century -- The Industrial Revolution, the Growth of Modern Medicine and the Birth ofthe Clinic -- The Clinical Gaze and the Doctor-Patient Relationship -- The 1815 Apothecaries Act -- An Upwardly Mobile Profession -- The 1858 Medical Act -- Victorian Club Government and Medicine's 'Club Mentality' -- Sorry Mrs, These are 'Men Only' Clubs -- Women and the Modern Medical Profession -- Medical Science, the Principle of Self-Regulation and the Doctrine of ClinicalAutonomy -- FROM CLUB GOVERNANCE TO STAKEHOLDER REGULATION -- Medicine and the Establishment of the National Health Service -- Changes in the GMC: Discipline, Education and Membership -- Lighting the Blue Torch Paper: The Retention Fee -- The Rise of NHS Management and the Patient Revolt -- The GMC and the Case of Alfie Winn -- The Spearing Bill -- New Public Management, Medical Audit and Evidence Based Medicine -- New Labour and Clinical Governance -- The Scientific Rationality of Performance Management -- Reforms in Undergraduate Medical Education -- The Central Issue of Continuing Medical Education -- Medicine's New Professionalism -- Bristol and Shipman - 'All Changed, Changed Utterly' -- The Kennedy Report -- Revalidation -- Annual Appraisal -- The Shipman Case -- A Culture of Medical Protectionism -- Professionally-led Regulation and the Donaldson Report -- Future Unknown (For Now) -- The 2008 Health and Social Care Act -- State and Professional Forms of Governance -- THE SOCIOLOGICAL ANALYSIS OF THE PRINCIPLEOF MEDICAL SELF-REGULATION.

The Sociology of the Professions -- The Functionalist Perspective -- Durkheim, Professionalism and Laissez Faire Capitalism -- Critiquing the Altruistic Foundations of Medical Privilege -- The Neo-Weberian Perspective -- Freidson and Medical Power -- Larson and the Indeterminate and Determinate Cognitive Dimensions ofProfessional Privilege -- The Exclusive Cognitive Identity of the Medical Club and the ClinicalMentality -- The Dominance of the 'Social Closure' Model -- The Feminist Critique -- Medicine and the State: The Invasion of Capital into the House of Medicine -- Governmentality and the Revival of Liberalism -- Liberal Government: Club Governance as the 'Natural State' of Things -- The "Enterprise Self" of Neo-Liberal Governmentality -- Expert Enclosures and Technologies of Performance and Agency -- The Contribution of the Governmentality Perspective -- A Critical Assessment of the Governmentality Perspective -- Synthesising the Neo-Weberian and Governmentality Perspectives: TheRestratification Thesis -- THE RESTRATIFICATION THESIS AND CHALLENGES TO MEDICAL AUTONOMY IN THE UK -- Challenging Medicine -- Medical Autonomy in Decline? -- Not Decline, But Restratisfication -- Support for the Restratification Thesis in the UK context -- Highlighting Current Gaps in the Sociological Literature -- Conclusion: Proposing an Empirical Investigation into Portfolio basedPerformance Appraisal within the Medical Club -- PERFORMANCE APPRAISAL INSIDE THE MEDICALCLUB -- Setting the Scene: Recent Changes in Medical Training -- A Different Type of Medical Trainee -- The Problem with Problem Based Learning -- Portfolio Based Performance Appraisal and Medicines New Professionalism -- Doctors under Surveillance? -- Bureaucratic Accountability and the Restratification Thesis -- Annual Appraisal and the Shipman Affect.

Appraisal and the Elitist Nature of the Medical Club -- The Appraisal Ritual Outside of the Medical Club -- 'Paperwork Compliance': A Definition -- The Appraisal Ritual within the Medical Club: 'BureaucraticAccountability' and 'Paperwork Compliance' -- Supporting 'Paperwork Compliance': The Structural Factor -- Supporting 'Paperwork Compliance': The Ideological Factor -- Conclusion: An Invaluable Baseline -- THE GOVERNANCE OF DOCTORS UNDER NEO-LIBERAL MENTALITIES OF RULE -- The Restratification Thesis -- The Neo-Weberian and Governmentality Viewpoints -- APPENDIX -- ACKNOWLEDGEMENT -- BIBLIOGRAPHY -- INDEX.