The accountable doctor during times of economic crisis: Constituting doctors in the Danish healthcare system in the 1930s and the 1970s

Abstract

While professions have traditionally been understood in contrast to bureaucratic and economic control in the sociology of professions, newer studies argue that New Public Management (NPM) reforms have led to a hybridization of professional roles. This article interrogates the economic responsibilization of physicians in the Danish welfare state in the 1930s and 1970s. In both periods, economic recession coupled with social reform contributed to a problematization of healthcare governance and the role of physicians. In the 1930s, social reforms required physicians to mediate between the economic interests of individual citizens and the state, while expectations of cost concern, administrative overview and social medicine shaped the role of physicians’ in the 1970s. While physicians expressed critique of the political attempts to make them economically accountable, they also demanded more regulation and political priority setting to guide their professional conduct. The analysis contributes to the scholarship on state-profession- relationships by demonstrating how the mutual constitution of the welfare state and the medical profession in Denmark took pace long before NPM reforms: for nearly a century, physicians have taken on responsibility for calculative practices and the distribution of public resources as an extended – but integrated – part of their professional role.