{"title":"Special Issue: A Southern African Dialogue on the Professions and Professional Work","authors":"Jens-Christian Smeby","doi":"10.7577/pp.3628","DOIUrl":"https://doi.org/10.7577/pp.3628","url":null,"abstract":"","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41924191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article concerns how dentists in a Swedish dental care organisation conceptualized work division when teamwork was requested by the senior manager and their boundary work in relation to dental auxiliaries. Data were drawn from semi-structured interviews with the dentists. The dentists’ made claims to tasks based on legislation and their wanting to focus on tasks that required their expertise. Dental auxiliaries may be reluctant to take on new tasks and become more involved in patient care, which indicates that they have some influence in the work division. Nevertheless, the dentists retained control as their invitation for dental auxiliaries in patient care was based on certain conditions. The dentists’ claim to certain tasks may have strengthened their identity as experts and reinforced boundaries between themselves and dental auxiliaries.
{"title":"The Complexities of Boundaries, Task Claims, and Professional Identity in Teamwork: from Dentists’ Perspective","authors":"C. Franzén","doi":"10.7577/pp.2689","DOIUrl":"https://doi.org/10.7577/pp.2689","url":null,"abstract":"This article concerns how dentists in a Swedish dental care organisation conceptualized work division when teamwork was requested by the senior manager and their boundary work in relation to dental auxiliaries. Data were drawn from semi-structured interviews with the dentists. The dentists’ made claims to tasks based on legislation and their wanting to focus on tasks that required their expertise. Dental auxiliaries may be reluctant to take on new tasks and become more involved in patient care, which indicates that they have some influence in the work division. Nevertheless, the dentists retained control as their invitation for dental auxiliaries in patient care was based on certain conditions. The dentists’ claim to certain tasks may have strengthened their identity as experts and reinforced boundaries between themselves and dental auxiliaries.","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45567111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Wilkesmann, Caroline Ruiner, Birgit Apitzsch, S. Salloch
In the last decades, managerial instruments have gained importance to medical decisions and the logic of managerialism is juxtaposed with the logic of medical professionalism. Recent changes in the hospital employment structure raise the question of contradictory logics not only at the organizational but also at the individual level. Therefore, we investigate the rise of locum doctors which is a relatively new phenomenon in Germany. Our qualitative interview study with 21 locum tenens, permanently employed physicians, and chief physicians shows that locum physicians re-contextualize professional standards in hospitals. According to their self-perception, patient care stays at the center of their medical practice regardless of economic, bureaucratic, and hierarchical requirements as well as hospital-specific routines. We argue that the interrelationship between professionalism and managerialism exists not only within organizations but also on an individual level of locum doctors.
{"title":"“I Want to Break Free”: German Locum Physicians Between Managerialism and Professionalism","authors":"M. Wilkesmann, Caroline Ruiner, Birgit Apitzsch, S. Salloch","doi":"10.7577/pp.3124","DOIUrl":"https://doi.org/10.7577/pp.3124","url":null,"abstract":"In the last decades, managerial instruments have gained importance to medical decisions and the logic of managerialism is juxtaposed with the logic of medical professionalism. Recent changes in the hospital employment structure raise the question of contradictory logics not only at the organizational but also at the individual level. Therefore, we investigate the rise of locum doctors which is a relatively new phenomenon in Germany. Our qualitative interview study with 21 locum tenens, permanently employed physicians, and chief physicians shows that locum physicians re-contextualize professional standards in hospitals. According to their self-perception, patient care stays at the center of their medical practice regardless of economic, bureaucratic, and hierarchical requirements as well as hospital-specific routines. We argue that the interrelationship between professionalism and managerialism exists not only within organizations but also on an individual level of locum doctors.","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7577/pp.3124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47176735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper outlines a neo-Weberian approach to state-sponsored social closure in professional formation. Despite its advantages, state decision-making is not typically well-defined or examined in neo-Weberian analyses. Neo-Weberianism is differentiated from Max Weber’s own work on social action and rationality, which generally provides a more subtle interpretation of state socio-political processes. The paper explores how policy formation can be more incisively analyzed inside the black box of state decision-making from a Weberian perspective. This is exemplified by the passage of the 1858 Medical Act in the United Kingdom establishing the state-supported medical profession. While further work is necessary in filling in the black box, this paper charts an important future path for neo-Weberian analyses of professions, and their relationship with the state.
{"title":"Neo-Weberianism, Professional Formation and the State: Inside the Black Box","authors":"M. Saks, T. Adams","doi":"10.7577/PP.3190","DOIUrl":"https://doi.org/10.7577/PP.3190","url":null,"abstract":"This paper outlines a neo-Weberian approach to state-sponsored social closure in professional formation. Despite its advantages, state decision-making is not typically well-defined or examined in neo-Weberian analyses. Neo-Weberianism is differentiated from Max Weber’s own work on social action and rationality, which generally provides a more subtle interpretation of state socio-political processes. The paper explores how policy formation can be more incisively analyzed inside the black box of state decision-making from a Weberian perspective. This is exemplified by the passage of the 1858 Medical Act in the United Kingdom establishing the state-supported medical profession. While further work is necessary in filling in the black box, this paper charts an important future path for neo-Weberian analyses of professions, and their relationship with the state.","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7577/PP.3190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49656582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The central role institutions play in the development of generalized trust is well established by previous research. Yet, the role of the professionals employed in these institutions has received considerably less attention. This paper explores whether confidence in welfare state professionals is important in maintaining a high level of generalized trust in the Norwegian context. It is hypothesized that professionals may influence people’s generalized trust both via their formal role as gatekeepers and in informal settings as part of social networks. The results are based on novel cross-sectional data, and indicate that confidence in welfare professionals is correlated with generalized trust, while the presence of welfare professionals in a social network is not significantly associated with generalized trust. The relationship between confidence in professionals and generalized trust indicates that alongside good institutions, good service provision is important in maintaining a high level of generalized trust.
{"title":"Putting a Face to Institutions: Professionals and Generalized Trust","authors":"A. Alecu","doi":"10.7577/PP.3100","DOIUrl":"https://doi.org/10.7577/PP.3100","url":null,"abstract":"The central role institutions play in the development of generalized trust is well established by previous research. Yet, the role of the professionals employed in these institutions has received considerably less attention. This paper explores whether confidence in welfare state professionals is important in maintaining a high level of generalized trust in the Norwegian context. It is hypothesized that professionals may influence people’s generalized trust both via their formal role as gatekeepers and in informal settings as part of social networks. The results are based on novel cross-sectional data, and indicate that confidence in welfare professionals is correlated with generalized trust, while the presence of welfare professionals in a social network is not significantly associated with generalized trust. The relationship between confidence in professionals and generalized trust indicates that alongside good institutions, good service provision is important in maintaining a high level of generalized trust.","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7577/PP.3100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41360133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vol 9 No 2 (2019)","authors":"Issue No","doi":"10.7577/pp.3488","DOIUrl":"https://doi.org/10.7577/pp.3488","url":null,"abstract":"","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7577/pp.3488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47536609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
By denigrating expertise and challenging the value of evidence-based statements, advice and policies, populism challenges professions and professionalism. Arguably it is imperative for the professions to meet the challenge: but how? Here we provide an approach by juxtaposing populism and professionalism; two complex, ambiguous and contested phenomena with different and rarely connected literatures. Ontic and ontological definitions of each are compared and a method is developed for juxtaposing elements of their ontic definitions. Elements compared are: Manichean distinctions; disintermediation; morality v. ethics; emotionalism v. rationalism; and transparency. These are used to further understanding of both populism and professionalism and to provide insights into different ways the challenge of populism can be met: fighting it head on, adjusting to reduce the import of criticisms and perhaps controversially, adopting or at least adapting certain populist elements.
{"title":"Juxtapositioning Populism and Professionalism","authors":"A. Friedman","doi":"10.7577/PP.3201","DOIUrl":"https://doi.org/10.7577/PP.3201","url":null,"abstract":"By denigrating expertise and challenging the value of evidence-based statements, advice and policies, populism challenges professions and professionalism. Arguably it is imperative for the professions to meet the challenge: but how? Here we provide an approach by juxtaposing populism and professionalism; two complex, ambiguous and contested phenomena with different and rarely connected literatures. Ontic and ontological definitions of each are compared and a method is developed for juxtaposing elements of their ontic definitions. Elements compared are: Manichean distinctions; disintermediation; morality v. ethics; emotionalism v. rationalism; and transparency. These are used to further understanding of both populism and professionalism and to provide insights into different ways the challenge of populism can be met: fighting it head on, adjusting to reduce the import of criticisms and perhaps controversially, adopting or at least adapting certain populist elements.","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7577/PP.3201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46144598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sociologists have paid little attention to the shifting significance of gender to professional work. Nevertheless, there is evidence that the meanings attached to gender, and the gendering of work, have shifted over time, such that the experiences of newer cohorts of professionals differ from those of professionals in previous generations. In this paper, we show how combining intersectionality theory and life course approaches facilitates the exploration of inequalities by gender, class, and race/ethnicity across generations and age cohorts. We present empirical research findings to demonstrate how this approach illuminates the convergence of gender and age in the professions to confer privilege and produce disadvantage in professional workplaces. Subsequently, we introduce the concept of meta-work—hidden, invisible and laborious work performed by non-traditional and disadvantaged professionals—through which they endeavor to cope with structural inequalities embedded in the professions. As professions and professional workplaces are still designed primarily for middle-class, dominant-ethnicity men, professionals who do not fit these categories need to invest extra time and energy to develop individual strategies and tactics to cope with professional pressures in and around their work. Meta-work is intrinsically linked to the traditional and normative ideals surrounding professional roles and identities, and therefore is intimately connected with professionals’ sense of self and their feeling of belonging to professional communities. Meta-work, and the tactics and strategies that result from it, are important coping mechanisms for some professionals, enabling them to deal with rapidly changing work realities and a lack of collegial support. Finally, we highlight several areas for future research on the intersections of gender and age in the professions.
{"title":"Gender and Age in the Professions: Intersectionality, Meta-work, and Social Change","authors":"Marta Choroszewicz, T. Adams","doi":"10.7577/PP.3432","DOIUrl":"https://doi.org/10.7577/PP.3432","url":null,"abstract":"Sociologists have paid little attention to the shifting significance of gender to professional work. Nevertheless, there is evidence that the meanings attached to gender, and the gendering of work, have shifted over time, such that the experiences of newer cohorts of professionals differ from those of professionals in previous generations. In this paper, we show how combining intersectionality theory and life course approaches facilitates the exploration of inequalities by gender, class, and race/ethnicity across generations and age cohorts. We present empirical research findings to demonstrate how this approach illuminates the convergence of gender and age in the professions to confer privilege and produce disadvantage in professional workplaces. Subsequently, we introduce the concept of meta-work—hidden, invisible and laborious work performed by non-traditional and disadvantaged professionals—through which they endeavor to cope with structural inequalities embedded in the professions. As professions and professional workplaces are still designed primarily for middle-class, dominant-ethnicity men, professionals who do not fit these categories need to invest extra time and energy to develop individual strategies and tactics to cope with professional pressures in and around their work. Meta-work is intrinsically linked to the traditional and normative ideals surrounding professional roles and identities, and therefore is intimately connected with professionals’ sense of self and their feeling of belonging to professional communities. Meta-work, and the tactics and strategies that result from it, are important coping mechanisms for some professionals, enabling them to deal with rapidly changing work realities and a lack of collegial support. Finally, we highlight several areas for future research on the intersections of gender and age in the professions.","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7577/PP.3432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47252193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper explores virtual health professionals (VHPs), digital health technology software, in Swedish health care. The aim is to analyze how health professionalism is (re)negotiated through avatar embodiments of VHPs and to explore the informants’ notions of what a health professional is, behaves and looks like. The paper builds on ethnographic fieldwork with informants working directly or indirectly with questions of digital health technology and professionalism. Discourse theory is used to analyze the material. Subjectification, authenticity, and diversity were found to be crucial for informants to articulate health professionalism when discussing human avatars, professional attire, gendered and ethnified embodiments. The informants attempted to make the VHPs credibly professional but inauthentcally human. A discursive struggle over health professionalism between patient choice and diversity within health care was identified where the patient’s choice of avatars—if based on prejudices—might threaten healthcare professionalism and healthcare professionals by (re)producing racism and sexism.
{"title":"Digital Health and the Embodying of Professionalism: Avatars as Health Professionals in Sweden","authors":"J. Hallqvist","doi":"10.7577/PP.2847","DOIUrl":"https://doi.org/10.7577/PP.2847","url":null,"abstract":"This paper explores virtual health professionals (VHPs), digital health technology software, in Swedish health care. The aim is to analyze how health professionalism is (re)negotiated through avatar embodiments of VHPs and to explore the informants’ notions of what a health professional is, behaves and looks like. The paper builds on ethnographic fieldwork with informants working directly or indirectly with questions of digital health technology and professionalism. Discourse theory is used to analyze the material. Subjectification, authenticity, and diversity were found to be crucial for informants to articulate health professionalism when discussing human avatars, professional attire, gendered and ethnified embodiments. The informants attempted to make the VHPs credibly professional but inauthentcally human. A discursive struggle over health professionalism between patient choice and diversity within health care was identified where the patient’s choice of avatars—if based on prejudices—might threaten healthcare professionalism and healthcare professionals by (re)producing racism and sexism.","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7577/PP.2847","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71367905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The public health sector in welfare states is increasingly subject to organisational changes, particularly in hospitals, as organisations comprise coali-tions of various (healthcare) professionals. In this context, due to interprofessional competition, knowledge claims play an important role in achieving jurisdictional control. In this paper, we investigate the manifestations of and health professionals’ reactions to competing institutional discourses. Through qualitative interviews with hospital management, middle managers, and staff employees at three hospitals in Denmark, we demonstrate how managerial attempts to control tenacious profes-sional bureaucracies are exercised through both bureaucratic forms of control and cultural-ideological modes of control with an introduction of new discourses of in-terprofessional teamwork. The findings suggest that hospitals seek not only to con-tain ambiguity through bureaucratic features of control, but also to cultivate it when seeking to strengthen cooperation between professions. Thereby, ambiguity itself becomes a mechanism for management.
{"title":"Interdisciplinary Promises and Hierarchical Ambiguities in a Danish Hospital Context","authors":"A. Hindhede, Vibeke Andersen","doi":"10.7577/PP.2862","DOIUrl":"https://doi.org/10.7577/PP.2862","url":null,"abstract":"The public health sector in welfare states is increasingly subject to organisational changes, particularly in hospitals, as organisations comprise coali-tions of various (healthcare) professionals. In this context, due to interprofessional competition, knowledge claims play an important role in achieving jurisdictional control. In this paper, we investigate the manifestations of and health professionals’ reactions to competing institutional discourses. Through qualitative interviews with hospital management, middle managers, and staff employees at three hospitals in Denmark, we demonstrate how managerial attempts to control tenacious profes-sional bureaucracies are exercised through both bureaucratic forms of control and cultural-ideological modes of control with an introduction of new discourses of in-terprofessional teamwork. The findings suggest that hospitals seek not only to con-tain ambiguity through bureaucratic features of control, but also to cultivate it when seeking to strengthen cooperation between professions. Thereby, ambiguity itself becomes a mechanism for management.","PeriodicalId":53464,"journal":{"name":"Professions and Professionalism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7577/PP.2862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49104276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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