The Influence of Managed Care on Supply of Certified Nurse-Midwives
An Evaluation of the Physician Dominance Thesis
Bibliographic Data
| ID | 2559954 |
|---|---|
| Authors | Heather Hartley (University of Wisconsin–Madison, corresponding author) |
| Year | 1999 |
| Volume | 40 |
| Issue | 1 |
| Pages | 87 |
| Publication date | 1999-03-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Journal of Health and Social Behavior (JOURNAL) |
| Journal identifiers | ISSN: 0022-1465 • E-ISSN: 2150-6000 |
| Publisher | SAGE Publications Inc (PUBLISHER) |
| DOI | 10.2307/2676381 |
| PMID | 10331324 |
| OpenAlex | W2318804818 |
| Language | EN |
| Citations received | 4 |
| References cited | 15 |
A key debate over the nature of professional power centers on the maintenance of physician dominance within the system of professions in health care. The changes in health care delivery and financing brought by managed care present a new context for evaluating the physician dominance thesis. I propose that increases in the supply of certified nurse-midwives, a "contending" health care professional group, are related to the expansion of managed care and may signal a decline in physician dominance. I analyze state-level data compiled from governmental, health professional, and industry sources to determine the influence of managed care market penetration, physician supply, state policy context, and demographic factors on the state-level supply of nurse-midwives. Results indicate that, despite high physician supply, nurse-midwife supply is higher in states with higher managed care penetration, as well as in those with more favorable state policy environments and a more educated demographic base. Outcomes from a series of hypothesis tests support my assertion that the expansion of managed care is altering the jurisdictional boundaries in the system of professions in health care, eroding the dominance of physicians while creating new openings for nurse-midwives
Business · Certification · Dominance (genetics) · Economic growth · Economics · Health care · Managed care · Management · Nurse-Midwives · Physician supply · Global Health Workforce Issues · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes
Brought to Bed
Consumerism in medicine
The Sociology of the Professions
The Changing Character of the Medical Profession
The Rise of Professionalism
Nurse practitioner and physician assistant practices in three HMOs
Medicaid prenatal care
The Reorganization of the Medical Profession
Professional Dominance
Boundary-Work and the Demarcation of Science from Non-Science
Professionalization of American Scientists
Paradigm Conflict in the Sociology of Service Professions
Ideology in the Reemergence of North American Midwifery
Patriarchy and Professions
Medicalization and Social Control
| Unique citing works | 4 |
|---|---|
| Citations per year | 0,17 |
| Citation span | 2002 - 2025 (24) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 4 |