Professionalism in the Welfare State

Abstract

Two models of profession-state relationships — “agency” and “functional sovereignty” — underlie contemporary relationships between the medical profession and the state in Canada. Each implies substantial influence for professional groups in the policy process, and considerable authority for professional groups over their own members. But the two models have different implications for the role of professional regulatory bodies and voluntary associations, and for the extent of collaboration between professional groups and the state. As the agenda of health policy develops these differences become more apparent. Conflict, both with in the medical profession and between the medical profession and the state, regarding the nature of profession-state relationships can be attributed in large part to a lack of consensus about these two implicit models.