Restratification revisited: The changing landscape of primary medical care in England and California

Abstract

Restratification, a process which involves medical elites exerting control over members of their profession, was seen by the US sociologist Eliot Freidson as helping to maintain the continued dominance of the medical model and the profession’s ability to determine its own fate. Drawing on interviews with primary care doctors in England and California this article reports the emergence of new strata or elites, with groups of doctors involved in both surveillance of others and action to improve compliance in deficient individuals and organizations. The article compares responses of primary care doctors to these developments and explores the implications in the context of Freidson’s predictions.