TABLE 1.

Summary of Hypothesized Threats to the Political Legitimacy of the Medical Profession

Core Hypothesis	Specific Sources of Declining Legitimacy
Core Hypothesis 1: Doubts about Professional Efficacy	1. Medical care is seen as not effective or reliable.
	2. “Health needs” are no longer seen as the appropriate standard for allocating medical resources.
	3. There is a general loss of faith in science and technology.
Core Hypothesis 2: Questions about Professional Agency	1. Physicians are thought to have become unduly money oriented.
	2. Physicians are seen as more concerned about controlling costs than about protecting the interests of their patients.
	3. Physicians are no longer thought to be committed to meeting the needs of the populations that they serve.
	4. Physicians are no longer thought to care for unprofitable patients.
Core Hypothesis 3: The Rise of Countervailing Authority	1. Support grows for the government to be more active in the health care system.
	2. Support grows for more active employers in the health care system.
	3. Support grows for a more active role for individual consumers of medical care.
Core Hypothesis 4: Violation of Professional Boundaries	1. Belief widens that communities should have control over health care.
	2. Lack of trust in the political activities of the medical establishment increases.
	3. Physicians are seen to have too much political influence over policymaking.