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October 10, 1966

Hidden Hierarchies: The Professions and Government

JAMA. 1966;198(2):212. doi:10.1001/jama.1966.03110150160060

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The thesis of this book is that the major professions in the United States today are organized in conservative and politically powerful associations which resemble medieval guilds. This illuminating idea, unfortunately, is presented in such a dull style that its force is greatly weakened. There are other original ideas here to reward the hardy reader. Mrs. Gilb, a political scientist who made this study while on a Social Science Research Council grant, points out that the big professional associations not only influence the making of laws but also exhibit some of the characteristics of government themselves, including internal legislative, executive, and even judicial functions. Although she concedes that our society still has elements of democracy and dynamic change, the author suggests that we are on the threshold of a worldwide era of social stratification and "rigidification of the whole system."

It may be difficult for members of the medical profession