The Industrialization of "Liberal Medicine" in France: A Labor Quality Conventions Approach

In: Historical social research: HSR-Retrospective (HSR-Retro) = Historische Sozialforschung, Band 46, Heft 1, S. 85-111

Abstract

This article seeks to analyze the evolution of the regulation of liberal medicine in France from the theoretical framework of the economics of convention. The recent introduction by the state of multiple management devices aimed at quantifying and evaluating the performance of physicians could be interpreted as a process of rationalization of medical practices. However, we propose to analyze the transformations in the regulation of liberal medicine as the transition from an inspired/domestic convention of healthcare quality to an industrial convention of healthcare quality. What is at stake is not improving the quality of care, but changing the conception of quality. Do doctors treat sick people or illnesses? This induces significant changes not only in the entire healthcare system but also in medical ethics. While the profession has historically been built against the market, it seems that the industrialization of healthcare opens the door to its commodification.