FROM PARADOX TO PARODY: A SOCIO-RHETORICAL THEORY OF COUNTER-INSTITUTIONAL MOVEMENT ORGANIZATIONS, APPLIED TO THE FREE CLINIC MOVEMENT

This study develops and applies a socio-rhetorical middle-range theory about one type of Social Movement Organization (SMO) which I label the "Counter-Institutional Movement Organization" (CIMO). The theory holds that (1) CIMOs face extraordinary internal contradictions as a result of having elected to oppose established institutions while providing services to beneficiaries akin to those offered by the opposed institution; (2) as a consequence of these contradictions, CIMOs more readily than other SMOs increasingly undergo institutionalization; (3) the ideological rhetoric of CIMOs changes concomitantly and predictably with increasing institutionalization. In these respects, it is argued, the CIMO is not altogether unlike other reformist SMOs; its problems are simply more severe. Hence, the CIMO may be viewed as a consummate case of the rhetorical problems of maintaining an anti-institutional stance while becoming increasingly similar to the institution one opposes.;The study focuses on the requirements and problems common to CIMOs, the alternative strategies open to CIMOs as they attempt to solve the problems and meet requirements, and on institutionalization as the predominant strategic choise. The study delineates three stages of institutionalization (Uninstitutionalized, Partially institutionalized and Fully institutionalized), based upon five major indices (stabilized funding source; paid and trained administrative staff; full-time, paid, trained general service staff; specialization of tasks; and career opportunities across and within organization type). These indices are applied to the Free Clinic Movement and to particular free clinic organizations in order to provide an illustrative example of a CIMO undergoing institutionalization.;The study additionally identifies and describes three rhetorics displayed by CIMOs as they evolve through the stages of institutionalization. The middle-range theory developed here states that the Uninstitutionalized stage is characterized by a Rhetoric of Division, the Partially institutionalized stage by a Rhetoric of Amelioration, and the Fully institutionalized stage by a Rhetoric of Respectability.;The study provides an analysis of the rhetorical artifacts of free clinics. Usng Kenneth Burke's dramatistic model for reading ideological rhetoric, this analysis involves close textual readings of a sample of free clinic documents from the three stages of institutionalization and from different places and times. The bulk of this analysis is of documents displaying the Rhetoric of Amelioration, which turns out to be the most complex and interesting rhetoric because it must deal somehow with the protracted period of institutional strain and change. This study closes with a discussion of the implications for future interpretive analysis of other CIMOs.;The research phase of this study focuses on one type of CIMO, the free clinic. Begun at Haight-Ashbury in 1967 as a counter-cultural alternative to the much-despised system of institutionalized medicine, the Free Clinic Movement has nurtured hundreds of autonomous free clinic organizations. Yet, virtually all of them have become increasingly institutionalized and publicly less virulent in their opposition to the "medical establishment." Utilizing field study methods as well as archival analysis of free clinic documents, this study illumines the socio-rhetorical theory about changes in free clinics as a function of increasing institutionalization.