Change in the governance of medicine: The politics of self-regulation

This article develops and applies an analytical framework. which shows how the political forces at work in the triangular relationship between medicine, society and the State interact to guide and constrain change in medicine's system of governance. Under pressure from society and the State, the medical profession is now obliged to reform itself and accept a higher degree of public accountability. This article explores the dimensions of the changes required, their likely impact on the political benefits which historically have sustained the triangular relationship, and hence the complex politics which must inevitably accompany such reforms.