White Collar by C. Wright Mills — Read

The white-collar world of medicine is still presided over by the physician as entrepreneur, and, as L. W. Jones has observed, ‘his ideology remains dominant. ' Yet the self-sufficiency of the entrepreneurial physician has been undermined in all but its economic and ideological aspects by his dependence, on the one hand, upon technical equipment that is formally centralized, and, on the other, upon informal organizations that secure and maintain his practice.

Medical technology has of necessity been centralized in hospital and clinic; the private practitioner must depend upon expensive equipment as well as upon specialists and technicians for diagnosis and treatment. He must also depend upon relations with other doctors, variously located in the medical hierarchy, to get started in practice and to keep up his clientele. For as medicine has become technically specialized, some way of getting those who are ill in contact with those who can help them is needed. In the absence of a formal means of referral, informal cliques of doctors, in and out of hospitals, have come to perform this function.