The erosion of professional authority: a cross-cultural inquiry in the case of the physician.

The extent to which the erosion of professional authority observed in the United States is also occurring in the United Kingdom and the U.S.S.R. is examined in the case of the primary care physician. Informal interviews with health practitioners in these diverse societies revealed that the model of the professions which bases physicians' autonomy and authority on the occupational characteristic of a monopoly of specialized knowledge is subject to some revision. Education of the patient emerged as a critical factor in eroding physician authority in both countries, while patient age affected authority relations differentially in the two societies. Despite variations in the level of bureaucratization of health care, the role of the physician, as gatekeeper to non-medical benefits, served to counteract the erosion trend in both. The legacy of deference to the upper classes in Great Britain and in the U.S.S.R., an ideology of health as a citizen's obligation plus the "mothering' ambience of a largely female personnel are varying societal characteristics which also affect physician authority.