Books by Bernard R. Blishen

There has been controversy for several years now in Canada over the various developments in insurance for medical care. The Canadian Medical Association is of course concerned with protecting the profession as well as the public: those who believe in a government-sponsored medicare plan claim that the medical profession’s reaction is based on self-interest. The debate was intensified by the 1962 medicare dispute in Saskatchewan, the publication in 1964 of the first two volumes of the Report of the Royal Commission on Health Services, and the more recent disagreement between the federal and provincial governments over the issue. Professor Blishen here examines the position of the medical profession in this debate as part of an ideological reaction to a rapidly changing society. The growth of scientific knowledge, demographic change, and shifting social values all have an impact on the medical profession: the doctors’ dilemma must be seen against this background.The focus of this analysis throughout is the physician’s role: the examples are Canadian but the ideologies and situations involved are relevant to all countries with a similar medical development.

Through the twentieth century, the nature of medical practice has changed more quickly, more dramatically, and far more publicly than that of any other profession in Canada. In this study Bernard Blishen identifies the social and political pressures on the medical profession and assesses how it has responded to them.Among the changes doctors have confronted are third-party pressures from government and hospital bureaucracies, greater public knowledge, improved technology, recognition of patients’ rights, and legal challenges. Blishen discusses how the doctors achieved dominance in the health field, reviews demographic changes within the profession and the larger population, examines data on the changing health status of Canadians, and charts physician supply against patient demand. He finds that the chief source of his profession’s collegial strength has been the homogeneity of its membership. This homogeneity is declining with increasing numbers of women and ethnic groups in the profession and increasing specialization.Blishen offers a comprehensive, quantified overview of a profession in transition, and suggests the implications of its changes for all Canadians.