Article: Serf or citizen: physician status and organizational structure. (Physician Executive Leadership).

OF ALL THE PLAYERS, PHYSICIANS ARE CONTEMPLATING the greatest personal transformation in the dynamic health care services industry. Those who have been self-governed may choose to surrender the power of self-determination. Some have already relinquished their agency.

As the influence of large organizations has increased,(1) some physicians have abdicated their organizational "citizenship," either partially or completely, and its consequent responsibility to contribute to governance. No doubt, the combined complexity of health care organizations, managed care requirements, reimbursement, and consolidation in the marketplace creates a daunting specter. But ...

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