Professions such as medicine are in the midst of profound change. This paper explores how recent stratifying forces within the medical profession relate to the trend toward salaried employment for physicians. Specifically, growing segments of female, black and Hispanic, and lower and middle class doctors are focused upon in the analysis. Several important structural forces related to managed care and the nature of medical work are discussed and examined as well. The results suggests that it is useful to consider factors internal to professions in explaining large-scale professional change. This does not mean forgetting about the role played by structure in this change. Instead, it supports incorporating stratification perspectives into studies of professionals and of considering micro levels of analysis which acknowledge and investigate the effects of intraprofessional diversity.