The unprecedented influence exerted by the medical profession in America can be understood in terms of the conflict perspective. Physicians dominate subordinate groups through power and coercion. Physicians enjoy a high degree of autonomy and dominance in their profession that places the health care consumer in a position of disadvantage. The medical profession has led the public to believe that health depends primarily on intervention by the doctor and that the essential requirement for health is the early discovery of disease. Physicians tend to view natural processes as medical disorders and to favor highly technical surgical procedures over less invasive methods. As a result, the critical roles of nutrition, environment, and personal behavior are marginalized. Failure to empower the patient in the control of disease has had a disproportionately negative effect on women, minorities, and the elderly as the medical profession, still dominated by white males, clings to the elitist attitude that the doctor knows best.
From its beginnings, the medical profession has benefitted from relentless legislative lobbying by the American Medical Association (AMA). By the beginning of the twentieth century, the AMA had succeeded in getting states to outlaw the activities of competing health practitioners (e.g., midwives and herbalists). Most of the practitioners of the competing health fields were women or minorities. When all fifty states later adopted stringent licensing laws for medical schools, the medical profession became predominantly white, male, and upper class: "These advantages served doctors well in their bids for support from legislators, virtually all of whom were also white men, and from the public, most of whom assumed that white men were inherently more competent than women and minorities." Then, as now, the high cost of medical training was financially prohibitive to students from the lower income segment of socie...