Chapter 7: Gig Economy and the Transformation of Professional Boundaries in Healthcare

Much of the body of literature analysing the gig economy focuses on its exploitation of low-wage workers and its role in increasing precarious work. This chapter approaches the topic from a different angle, focussing on the contribution of the gig economy to the declining power of the medical profession. As well as facilitating and promulgating contingent work in healthcare, the gig economy disaggregates medical work into isolated on-demand micro-tasks on digital platforms. This has implications for the status and power of the medical profession, the doctor–patient relationship, and inter-professional boundaries in healthcare. The mechanisms through which these dynamics unfold, as well as the inter-related factors that support the transformations in the allocation and content of medical work, are discussed. These include the implications of heightened transparency of medical work resulting from unbundling of jobs, commodification of medical professionals, and platform-based vulnerabilities such as rating systems that impact doctor–patient relationships. Closure theory is drawn on to illuminate the dynamics of the transformation in professional boundaries and the arising conflict that it entails for the healthcare workforce at different levels. The conflict is theorised as an insidious exercise of closure by allied health professionals on the remit of the medical profession, which challenges remuneration, authority, and other exclusionary benefits traditionally accrued to the medical profession.