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Changing professions

General Practitioners’ perceptions of autonomy on the frontline

Jenny M. Lewis

Centre for the Study of Health and Society, University of Melbourne

Timothy Marjoribanks

Sociology Programme, University of Melbourne

Marie Pirotta

Department of General Practice, University of Melbourne

Professional autonomy is a much-used concept which has operated with scant empirical attention directed at understanding its meaning among practitioners. This study investigates how General Practitioners (GPs) understand their professional autonomy, and what they perceive to be the main threats to it. Four focus groups were attended by 25 GPs in Melbourne. We found that GPs aspire to an ‘ideal type’ of professional who has the freedom to determine what is best for patients, but they believe their autonomy is threatened by financial constraints, greater accountability requirements, and more demanding patients. These findings reveal how GPs understand autonomy in their practice, and indicate that their concerns may have little to do with the deprofessionalization and proletarianization theses. Micro-level studies of GPs in the workplace, combined with greater understandings of different aspects of professional autonomy, appear useful in understanding how GPs’ work and autonomy is changing.

Key Words: deprofessionalization • health policy • medical profession • professional autonomy • proletarianization

Journal of Sociology, Vol. 39, No. 1, 44-61 (2003)
DOI: 10.1177/0004869003039001312
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