Setting Doctors’ Fees

In all of these circumstances, doctors’ autonomy has diminished. Administrators have taken over decisions formerly made by individual doctors such as setting doctors’ fees and work schedules, requiring doctors to obtain authorization before scheduling surgeries or prescribing certain medications, and expecting doctors to follow practice protocols that establish treatment guidelines aimed at providing the best—but also most cost-effective—treatment for different conditions.

Meanwhile, concern about costs has led corporations to replace doctors with radiation technologists, pharmacists, nurse practitioners, and other allied health personnel. This shift has reduced both doctors’ bargaining power with administra- tors and their power over other health occupations.