• G Nigenda and A Solórzano.
• Instituto Nacional de Salud Pública, Mexico.
• J Health Polit Policy Law. 1997 Feb 1;22(1):73-99.

AbstractThis study advances our understanding of the relationship between the state and the medical profession in countries where health care services are used as instruments of economic and political control. As a general argument, we maintain that the corporatist nature of the Mexican state impedes the medical profession from achieving autonomy and control over its professional activities. In contraposition to medical professions in developed societies, the nature of the Mexican profession is shaped by state policies and by its reiterated efforts to act independently of the state's tutelage. We analyze this dynamic interaction through three different historical epochs that reflect the complexity and uniqueness of the Mexican medical profession. Whatever attempts the profession has made to control the medical curriculum, the licensing process, the market, or the specific laws that affect its own field, the Mexican state has responded with measures that systematically divide and antagonize the different factions of medical associations. The result is a highly fragmented and disenfranchised medical profession with dissimilar political, professional, personal, and academic aims. In the final analysis, the interests of the corporatist Mexican state prevail over the interests of the groups, including doctors. The evisceration of the medical corps by the Mexican state results in a profession with low salaries, higher rates of unemployment, atomization in terms of political representation, and heavily co-opted medical organizations that seem to neglect the overwhelming health care needs of the Mexican people.

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