Change in the control of health care systems in Europe Implications for professional autonomy

Major changes are taking place in European health care systems,especially those in the former communist countries. However,in Western European countries reorganization is also on itsway, guided by the rhetoric of deregulation and competition.This might lead to a convergence in the institutional controlof health care systems, although it appears that different pathshave been chosen by Eastern European health care systems andWestern national health services. It is argued that the implicationsof these changes for the professional autonomy of doctors differand this is influenced by the way health care changes tie upclinical autonomy and economical autonomy.