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Jurisdictional control of conservative spine care : chiropractic versus medicine

Author: Marion Busche McGregor-Triano; University of Texas at Dallas. Graduate Program in Political Economy.
Publisher: 2006.
Dissertation: Ph. D. University of Texas at Dallas 2006
Edition/Format:   Thesis/dissertation : Thesis/dissertation : Manuscript   Archival Material : EnglishView all editions and formats
Summary:
The purpose of this study was to investigate the inter-professional struggle between higher and lower ranked working groups. In particular this research was intended to evaluate the strategies that a minor profession might successfully undertake in order to gain market share held by a dominant player, when the same jurisdiction is contested. Although professions have historically been granted exalted status among  Read more...
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Details

Material Type: Thesis/dissertation, Manuscript, Internet resource
Document Type: Book, Archival Material, Internet Resource
All Authors / Contributors: Marion Busche McGregor-Triano; University of Texas at Dallas. Graduate Program in Political Economy.
OCLC Number: 76288581
Notes: Includes vita.
Description: xvi, 203 leaves : illustrations (some color) ; 28 cm
Responsibility: by Marion Busche McGregor-Triano.

Abstract:

The purpose of this study was to investigate the inter-professional struggle between higher and lower ranked working groups. In particular this research was intended to evaluate the strategies that a minor profession might successfully undertake in order to gain market share held by a dominant player, when the same jurisdiction is contested. Although professions have historically been granted exalted status among society's working groups, that status may be in danger, as the combined forces of the marketplace and changes in knowledge flow erode their revered characteristics. Such changes may result in an evolution from a monopoly position for a dominant profession, to at least oligopoly as competitors vie for a stronger presence. A case study approach was used in combination with System Dynamics computer simulation. Medicine was chosen as the dominant profession, since efforts to manage healthcare expenditures have fostered attitudes that support substituting lower cost professions. Chiropractic was chosen as the competitor, due to its independent status, the recent popularity of complementary and alternative medicine (CAM), and its prominence in the CAM field. The jurisdiction of interest was neck and/or back pain---currently the dominant market for chiropractic. Informed by theory of inter-professional competition, two strategies were hypothesized to aid a minor profession in gaining or securing market share. The first posited an increase in academic abstract knowledge and the second suggested an increase in professional association membership. In addition, it was hypothesized that an increase in supply of the dominant profession would adversely affect the minor profession's bid for jurisdictional control, as would pressure on the major profession from external sources such as health management. Simulation results suggested that dramatically increasing the academic abstract knowledge base of the minor profession had only a minimal impact, after an extended delay. No differences were seen as a result of increasing association membership. Negative effects on the minor profession's market share were observed when the supply of the dominant player was increased and when external pressure was intensified. In general it was concluded that for the limited relationships and test conditions studied here, simulation results favored medicine's monopoly power.

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