Valenzuela Candelario J
Departamento de Anatomia Patológica e Historia de la Ciencia, Universidad de Granada.
Dynamis. 1994;14:269-304.
This article examines the organization of extrahospitalary medical care in Spain during the nineteenth century. We have attempted to use contemporary sources (newspapers, medical monographs, parliamentary records) within the background of the establishment of liberal politics in Spain. Our central hypothesis was that medical practice has to be considered a helping profession, to which free private practice was associated in an opportunistic manner. Faced with the mirage of "market" deregulation, foreseen even by the professional élite, regulation by the state and corporative pressures framed the public system of health care, and favored consolidation of the profession. Successive reforms in the regulation of medical practice reflected the marked anatagonism between city and country. The resulting hybrid model made public practice compatible with private practice by physicians on the state's payroll.
本文考察了19世纪西班牙的院外医疗护理组织情况。我们试图在西班牙自由政治体制建立的背景下，运用当代资料（报纸、医学专著、议会记录）。我们的核心假设是，医疗实践必须被视为一种助人的职业，自由的私人执业以一种机会主义的方式与之相关联。面对即便专业精英都预见到的“市场”放松管制的幻影，国家监管和行业压力构建了公共医疗体系，并有利于该行业的巩固。医疗实践监管方面的一系列改革反映了城乡之间明显的对立。由此产生的混合模式使公立医疗实践与领取国家工资的医生的私人执业得以兼容。
