Eliot Freidson introduced the concept of the “market shelter” to designate the unique institutional position that professions hold in society. A market shelter shields professional workers from competition, third party and government interference, and other market forces. Once put in place through legal mandates, however, it remains unclear how market shelters weather with political and economic changes and provide benefits for professionals, the state, and the public. This article reviews how clinical medicine and forensic medicine reacted to outside pressures to address the problem of practice variation to understand under which conditions stable market shelters may be professionally harmful and how less sheltered professions may instead use the fight against external challenges to solidify their professional position.
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