Administrative Medicocracy: A Comparative Analysis of Physicians' Professional Dominance over Public Administration in Iran, Developed, and Developing Countries

The disproportionate presence of medical graduates in Iran's policy-making and managerial positions is a long-standing yet under-theorized phenomenon, rooted in Qajar-era study missions and institutionalized after ۱۹۷۹, particularly following the integration of medical education into the Ministry of Health in ۱۹۸۵. This study conceptualizes and critically examines what the author terms administrative medicocracy: the extension of a clinical profession's legitimate authority beyond its own jurisdiction into the general domain of public administration, absent any corresponding mechanism for verifying managerial competence or containing conflicts of interest. The research is qualitative and explanatory-critical, combining thematic analysis of legal, regulatory, and scholarly documents with a most-different comparative design. The comparison is deliberately structured along the developed/developing axis: developed cases (the United States, Switzerland, the United Kingdom, the Netherlands, and an OECD panel) and developing cases (Latin American technocracy in Colombia, Peru, and Mexico, and China's elite transformation). The findings show that physician presence in management is a near-universal phenomenon and, within clinical service organizations, is often benign or even beneficial; what distinguishes the Iranian case is not this presence but the absence of an institutional counterweight, combined with a vertical integration of governance and provider roles that converts professional prestige into a general credential of competence. The study argues that administrative medicocracy is best understood as a form of cultural policy capture and recommends separating governance from provider roles, adopting job-based competence systems, and mandating conflict-of-interest management.

کلیدواژه ها:

Administrative medicocracy ، Policy capture ، Conflict of interest ، Technocracy ، Comparative public administration