This paper focuses on the major evolutions of cancer care in France since the beginning of the 1990s. These evolutions have consisted in the development of evidence-based guidelines and in the creation of multidisciplinary, inter-organizational staffs intended to improve therapeutic choices. These organizational tools are at the core of oncology networks between hospitals that have been created for a few years.
These transformations can be interpreted as a response of the medical profession to the evolutions of the French healthcare system, characterized by the increasing role and rights of patients and by the rise of public management concerns. Nonetheless, it will be argued that, in order to fully understand these changes, one has to consider the complex and ambiguous competition that takes place between physicians and between medical institutions. One may then be able on the one hand to understand why some physicians found some interest in these new organizational tools and on the other hand to identify some of their consequences on the organization of oncology
