Adapting, Resisting, and Negotiating

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Abstract
The organization and economics of health care in the United States are in the midst of profound change. Yet we know little about how individual physicians cope with and respond to this change on a daily basis. This article examines primary care doctors in two different work settings to see how professionals attempt to actively deal with structural developments in their environment. The findings show the complex, uncertain, and ongoing process of professional adaptation and how characteristics of the specific work context play a mediating role in this adaptation. They also provide a rationale for bringing the study of individual-and group-level processes back into the literature on the professions.

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