SPONSORSHIP AND THE CONTROL OF PHYSICIANS.

This article examines the structural relations between physicians and those who capitalize them in some of the most important types of medical settings and financing arrangements. As suggested by proletarianization theorists, physicians, like almost all other producers of commodities or services in advanced economies, have now become dependent on external sources of capital. Yet for reasons peculiar to medicine, providers of capital are not primarily capitalist employers and have been differentiated in a manner that significantly fragments their class-wide interests and weakens their capacity to manage physicians' work. Historically, proletarianization has meant the emergence of a production system in which producers become wage-employees, dependent on their employer to provide capital for two fundamental purposes. The first was capitalization of the process of production itself. Because of mechanization and increased capital-intensiveness of production, producers were unable themselves to purchase necessary fixed-capital. Second, producers increasingly became dependent on external capital for mediation of the market. Geographical expansion as well as growing competition for local markets increased the capital required for recruitment, promotion, and distribution to the market.