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Professional Monopolies in Medicine
Mark O. Baerlocher, MD;
Allan S. Detsky, MD, PhD
JAMA. 2009;301(8):858-860.
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Physicians, like other professionals in society, stake out a scope of practice that gives them ownership rights to performing tasks within a specific clinical territory. Just as lawyers reserve exclusive rights to practice law and pharmacists to dispense pharmaceuticals, so also have physicians demarcated subspecialty lines. Oncologists are the cancer experts, obstetricians bring children into the world, pediatricians take care of children, and neurosurgeons perform brain surgery. These ownership rights constitute professional monopolies.
In general, most societies encourage free competition and discourage monopolistic behavior, which restricts supply and raises prices above true costs. Societies do so through the legal system via antitrust legislation to prevent price fixing. Legal exceptions are granted in a few cases to promote other societal goals. In public utilities, for example, monopolies were formerly granted for reasons of standardization and economies of scale (ie, larger size reduces . . . [Full Text of this Article] Examples of Turf Battles
Author Affiliations: Department of Radiology, University of Toronto, Toronto, Canada (Dr Baerlocher); and the Departments of Health Policy Management and Evaluation and Medicine, University of Toronto, and Departments of Medicine, Mount Sinai Hospital and University Health Network (Dr Detsky), Toronto, Canada.
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