Eliot Freidson, a sociologist at New York University who studied the inner workings of society’s professions, particularly the way doctors are organized to practice medicine, died on Dec. 14 in a hospice in San Francisco. He was 82.
Dr. Freidson (pronounced FRIDE-son) studied the hierarchy and organizational structure within law and engineering, but he was most widely known for his long-running study of medicine. He was interested in the profession’s makeup of largely self-regulating bodies with unique expertise and, as a result, in its having uncommon ethical obligations to society.
In his influential book “Profession of Medicine: A Study of the Sociology of Applied Knowledge” (1970), Dr. Freidson looked comprehensively at the field’s history and internal politics, and at the powerful bonds formed between doctor and patient.
In a later book, “Doctoring Together: A Study of Professional Social Control” (1976), he expanded on his observations and concluded that “doctors had no effective way of disciplining people in their group for incompetence or ethical lapses,” said Howard S. Becker, a former professor of sociology at Northwestern University.
“He found that, as a result, doctors tended to steer their own patients away from incompetence and unethical behavior,” Dr. Becker continued, as an unspoken and unofficial mechanism to regulate their profession.
In the 1980’s and 90’s, Dr. Freidson warned of increasing commercialism and bureaucratic control as threats to the independence of professions, citing the proliferation of health care management organizations and the erosion of doctors’ autonomy in practicing medicine.
In his book “Professionalism Reborn: Theory, Prophecy and Policy” (1994), Dr. Freidson reported observing broader changes in the professions, in which “everyday practitioners become subject to the control of professional elites who continue to exercise the considerable technical, administrative and cultural authority that professions have had in the past.”