The Sociology of the Professions

SAGE Publications

Keith M Macdonald

• Publisher: SAGE Publications Ltd
• Year: 1995
• Print ISBN: 9780803986343
• eBook ISBN: 9781446231715
• Edition: 1
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

This much-needed book provides a systematic introduction, both conceptual and applied, to the sociology of the professions.

Keith Macdonald guides the reader through the chief sociological approaches to the professions, addressing their strengths and weaknesses. The discussion is richly illustrated by examples from and comparisons between the professions in Britain, the United States and Europe, relating their development to their cultural context. The social exclusivity that professions aim for is discussed in relation to social stratification, patriarchy and knowledge, and is thoroughly illustrated by reference to examples from medicine and other established professions, such as law and architecture. The themes of the book are drawn together in a final chapter by means of a case study of accountancy.

1

Sociological analysis of the professions

The subject of this book is what the English-speaking world calls ‘professions’, and which for the sake of sociological clarity we should refer to as ‘occupations based on advanced, or complex, or esoteric, or arcane knowledge’; or better still (although this has the disadvantage of excluding the priesthood) to follow Murphy (1988: 245) and to speak of ‘formally rational abstract utilitarian knowledge’. ‘Professional’ and similar terms have a wide range of uses in everyday speech, many of which are value-laden, while in some European languages the Anglo-American usage has no direct equivalent (Geison, 1984: 3, 10). So when the word ‘professions’ is used in this book, it is as a kind of shorthand, not as a closely defined technical term.¹

Another way of looking at the subject matter of the present study is to say that it deals with those occupations to which the concept ‘professional project’ can be usefully applied. This is a term employed by Larson (1977), which forms the linchpin of her study of professionalization, and which has been used as the basis for much important work on the professions. This is not to say that it has been taken without comment or criticism as the foundation of a sociological orthodoxy, but it is the case that many sociologists and social historians working in this area since its publication acknowledge a debt to it, or offer constructive criticism or modification. Some work on the professions may be said to talk past it, and indeed some comments have been strongly critical; but all these assessments, positive and negative, will be reviewed and put in context later in this chapter.

The review of the theoretical work on the professions which follows falls into three sections, of which the discussion of Larson’s work is the central one: it is preceded by an outline of earlier theories, to show how Larson (1977) represented a significant departure from some of these theories and an important development of others. The final section reviews and evaluates research and analysis published since Larson’s, and considers the extent to which her model requires modification or extension in order to provide the basis for a workable theory of the professions. Of particular relevance to this exercise is the writing of Weber and neo-Weberians and their use and development of the notion of social closure. In this, as in the rest of the book, the theme will be to argue for the advantages of theories of action as opposed to those of structure; and for multiplicity of the bases of action, rather than for the predominance of material interests.

Functionalist sociology and the professions

The sociological study of the professions has, in the past decade or so, been strongly influenced by the model of professionalization formulated by Larson (1977), in The Rise of Professionalism. This took as its starting point the work of Freidson (1970a, 1970b) and was wholeheartedly endorsed by him (on the cover of the paperback edition) as being ‘the most important book on professions to be published in years’. It represents a development of and a divergence from the ‘power’ approach to the sociology of the professions that was in vogue at that time and represented a complete break from the functionalism that dominated mid-twentieth-century social theory and which traced its origins back to Durkheim (1958).

Until the late 1960s the sociology of the professions was an area in which functionalist theory flourished, due in large measure to the emphasis which Durkheim (1957) put on professional ethics. His view that the division of labour and occupational groups represented the moral basis for modern society led him to focus on professions as entities which embodied all the eufunctional social forces which he valued and which would provide the model for corps-intermediaires, that is, those institutions which are to be found at a level between the individual and the state. These he believed would save modern society from the breakdown in moral authority, which in his view threatened it. The development of this view by a variety of sociologists in the middle years of this century has been admirably summarized by Johnson (1972). They range from Tawney ([1921] 1982) to Halmos (1970) and in some cases reach a level of uncriticality that is hard to credit. Carr-Saunders and Wilson (1933: 497), for instance, saw professions as being one of the most stable elements in society which

inherit, preserve and pass on a tradition … they engender modes of life, habits of thought and standards of judgement which render them centres of resistance to crude forces which threaten steady and peaceful evolution … The family, the church and the universities, certain associations of intellectuals, and above all the great professions, stand like rocks against which the waves raised by these forces beat in vain.

Johnson goes on to quote another author writing thirty years later:

Our professional institutions are … an important stabilizing factor in our whole society and through their international associations they provide an important channel of communication with the intellectual leaders of other countries, thereby helping to maintain world order. (Lynn, 1963: 653)

Other writers brought a more reasoned approach to the professions, but most emphasized their socially functional traits such as altruism (Marshall, 1963: 158–9) or ‘collectivity-orientation’ (Parsons, 1954). This school of thought also included most of those writers who took the ‘traits’ approach to the professions and believed the sociological task on this topic to consist of listing the characteristics of an ideal-typical profession against which actual examples of occupational groups could then be assessed as more or less professional. Goode (1957) is a prime example of this approach, while Etzioni (1969) takes the step of classifying occupations into ‘professions’, ‘semi-profesions’ and (presumably) ‘non-professions’. In a more positivistic vein still, Hickson and Thomas (1969) produced a Guttman scale of professionalism.

However, by the early 1970s, functionalist orthodoxy and to some extent the positivism that had been its counterpart since the days of Durkheim, were being increasingly criticized and rejected. Up to that date, the mainstream of the sociology of the professions was concerned with the ‘traits’ of professionalism, their definition and their use in classifying occupations or placing them on a continuum of which only one end was specified. This concern was not only tied in with functionalism but, as I shall argue below, was not really a proper sociological enterprise.

The functionalist view of the professions never completely dominated this area of sociology, partly because some functionalists were aware of what they called its bias, partly because the study of professions rubbed shoulders with other aspects of sociology, where a less euphoric view of their role in society obtained, and most importantly because, especially in the USA, a variety of sociology with a quite different approach was also interested in the professions.

Robert Merton was more aware than most of his contemporaries that the functionalist approach was not beyond criticism. In fact, he set out (Merton, 1957) a detailed defence against its critics, but as Gouldner (1970: 334) points out, his defence is against a charge of bias, not against fundamental criticisms, and even the defence against this bias is flawed.

None the less, Merton’s position hinges on the need to distinguish between eufunction and dysfunction and this formed the basis for his own and others’ (for example, Blau, 1955) studies which showed the less than functional aspects of bureaucracy. These studies included work on professionals, and he is quite scathing about some groups, coining the well-known phrase about ‘trained incapacity’ (Merton, 1947: 79–81) and writing of those who ‘come to be indoctrinated with an ethical sense of limited responsibility’ (1947: 80).

The same kind of critique was levelled at professions by other non-functionalist sociologists, such as Mills (1956) who, like Merton and the functionalists, were interested in organizations, bureaucracy and bureaucrats. Mills’s view was that bureaucracy and managerialism were becoming such dominant forces in modern society that professions were increasingly being sucked into administrative machines, where knowledge is standardized and routinized into the administrative apparatus and professionals become mere managers (1956: 112). Professionals are certainly not eulogized in work of this kind, but in addition to taking a critical approach, it gives a new importance to the question of ‘knowledge’ in relation to professional occupations. This matter was adumbrated but not explored by Weber (1978: 220–2), when he introduces technical qualifications as a characteristic and a basis for promotion of bureaucrats. What later writers – starting with Mills (1956) and continuing with, for example, Oppenheimer (1973) – observed was that professions like other organizational entities in modern society are under pressure to systematize their knowledge and thereby make it potentially accessible to lay members of society, or at least to less skilled occupations.

Interactionist alternatives

Although functionalism dominated mid-century sociology and social anthropology and still casts its long shadow over textbooks, the school of symbolic interactionism in America always maintained an alternative view and tacitly contradicted the theme of ASA President, Kingsley Davis (1959: 757–73) that ‘we are all functionalists now’. This was particularly true for the sociology of occupations, in which Everett Hughes (1958, 1971) was pre-eminent and which gave rise to such significant works in the sociology of the professions as Becker et al.’s Boys in White (1961) and Freidson’s The Profession of Medicine (1970b). These studies were the outcome of a tradition which took as its subject matter the actions and interactions of individuals and groups, how they constituted their social worlds as participants and how they constructed their careers. The professional principles of altruism, service and high ethical standards were therefore seen as aspects of the day-to-day world within which members lived, worked and strove and which therefore appeared as less than perfect human social constructs rather than as abstract standards which characterized a formal collectivity. Trainee physicians were portrayed as developing cynicism rather than altruism (Becker et al., 1961), doctors appeared as wielders of power, not servants of the social good (Freidson, 1970a) and most of the professional ‘traits’ were shown to have an ideological tinge (Daniels, 1973) or even to be characterized as ‘mythology’ (McKinlay, 1973b: 62).

Professional power

It was this tradition which gave rise to one version of the ‘power’ approach that a decade later came to dominate sociological writing on the professions (Hall, 1983:11). In the hands of Freidson (1970a), for example, this gave a strong impetus to a new kind of study of the professions, although it was the same author who recognized that there was a real danger, that in the work of some writers, the multi-trait approach had merely been replaced by ‘a single … explanatory trait or characteristic’ (Freidson, 1983: 33).

In fact, the so-called power approach included quite a range of emphases from different authors and came close to being a mere label to refer to all those who had abandoned the earlier orthodoxy. Freidson himself makes very little use of the word ‘power’, preferring the term ‘organized autonomy’ (1970b: 71), reflecting its ‘licence and mandate’ to control its work (Hughes, 1958: 78–80), granted by society (or in effect the state), by virtue of winning the support of a political, economic or social elite (Freidson, 1970b: 188). Freidson actually comes close to overusing ‘autonomy’, in the same way as some others overuse ‘power’, when he refers to medicine’s ‘autonomy to influence or exercise power over others’ (1970b[1988: 383]). This is more accurately described as ‘dominance’, as indeed his book with this title would suggest. The main themes in this strand of his work are how the medical profession has attained its autonomy, especially in the US and British contexts, and the way in which this is extended into ‘dominance’ over kindred occupations; and further, the exercise of autonomy to prevent outside interference and supervision, while at the same time failing to exert formal control over members, relying merely on the informal private ostracism of non-compliant members.

One can see how such an analysis of a profession came to be labelled ‘the power approach’, even though the author rarely used the term himself, and how it was extended to others working on the same general theme. What is more surprising is that it became applied to nearly all post-functionalists, and that this has led some later writers, such as Abbott (1988) and of course Hall (1983), to regard Berlant (1975) and Larson (1977) as cast in the same mould. From the point of view to be developed in the present work and in the eyes of others (such as Witz, 1992), Berlant, Larson, Parry and Parry (1976) (et cetera) were developing a neo-Weberian line of analysis, which certainly concerned itself with power, but chiefly in so far as power cannot be separated from the conflicts that constitute the main focus of such studies, in the sense that the outcome of conflict will often result in one of the protagonists achieving a superior and therefore more powerful position.

But while this new orthodoxy deriving from interactionism and the work of Freidson became an important model for the sociology of the professions in the USA, in Britain a rather different power approach came to be accepted, deriving from Johnson’s (1972) analysis. This approach focused on the relations between producer and consumer of professional services and the extent to which the producer could or could not control the relationship and thereby benefit from it. While Marx is not referred to in this context, the centrality of the ‘producers’ and their relationships, together with the tenor of other work by this author, (e.g. Johnson, 1977, 1980) leads one to see it as deriving more from a Marxian tradition.

However, although the Johnson approach became accepted on one side of the Atlantic, it was rarely acted upon. Heraud (1973) refers to the Johnson schema, but references by other writers are often to other points made by Johnson rather than his typology (Fielding and Portwood, 1980; McKinlay, 1973a). Works originating in the United States often ignore Johnson completely and while that may be the consequence of a kind of academic Monroe Doctrine,² absence from the pages of Spencer and Podmore (1986), for example, suggests his typology is more intellectually interesting than it is empirically relevant. This may well be because, as Freidson (1983: 33) implies, it is a variant on the trait approach; but the problem of its value as a research model may well lie in the fact that the relationship of producer/consumer of professional services is itself a product of the availability of a number of power resources on either side, and of historical/cultural circumstances, for all of which the producer/consumer relationship is only a sort of shorthand. The interactionist version of the power paradigm attained considerably more popularity among American researchers; even so Freidson (1983: 33) was cautious about it, while Hall (1988: 273) thought that it appeared to be ‘no longer meaningful to sociologists’ and believed that other authorities, such as Rueschemeyer (1987: 461–2), thought likewise.

Professions as social actors

The ‘power approach’, whether derived from interactionist or Marxian traditions, was undoubtedly more fruitful than the work of functionalists and the related delineation of professional ‘traits’. However, within interactionism another line of thought was coming to the fore, one which developed more slowly, more insightfully and, most important, more radically. This was the view that basically sociologists were asking the wrong question.

Like the Magrathean computer, Deep Thought, sociologists had, in many respects, got the answer, although it was rather more complex than ‘forty-two’, and probably less elegant (Adams, 1979). The question eluded them and it was only by degrees that the sociological community, or that part of it interested in occupations, realized the significance of what Everett C. Hughes (1963) had written:

in my own studies I passed from the false question ‘Is this occupation a profession’ to the more fundamental one ‘what are the circumstances in which people in an occupation attempt to turn it into a profession and themselves into professional people?’

Some sociologists realized that Hughes was saying something radical about the sociology of the professions, but it seems that they did not really understand what. Jackson (1970) quotes this passage from Hughes and so does McKinlay (1973a: 66) but both fail to grasp the fact that Hughes is talking in terms of action, not structure. Both appear to think that to shift from ‘structure’ terminology to that of ‘process’ is to have adopted a new paradigm whereas they are basically the same. Observe the terminology used by McKinlay:

several dominant occupations (especially medicine and law) have come to occupy uniquely powerful positions in Western societies from which they monopolistically initiate, direct and regulate widespread social change. Several of the mechanisms which have facilitated these developments have been identified and discussed. Principal among them are the emergence of a mythology concerning professionalism … (1973a: 77, emphases added)

Although words such as ‘initiate’ and ‘direct’ refer to action, the phrases emphasized imply the existence of a structure or a system within which things happen. In the passage quoted from Hughes people act.

In spite of this misperception, McKinlay does make the important point that from the sociological point of view ‘there is no logical basis for distinguishing between so-called professions and other occupations’ (McKinlay, 1973a: 65). McKinlay goes on to argue that the definitions of ‘traits’ are basically ‘myths’ imposed on ‘a gullible public’, which is perhaps no more than to put flesh on the bones of George Bernard Shaw’s bald assertion in The Doctor’s Dilemma (1906) that ‘all professions are conspiracies against the laity’. But he omits to emphasize the counterpart to the point he makes, something which can be found in Becker (1970: 91) and rather later in Freidson (1983: 27); namely that ‘profession’ is a lay or folk term and that assessing whether an occupation is or is not a profession, is a ‘semi-profession’, or is more or less professional than other occupations, is what the ‘folk’ do, and it is not the real task of sociology to try to do it for them scientifically. S...

Table of contents

• Cover Page
• Title page
• Copyright
• Contents
• Dedication
• Preface
• 1 Sociological analysis of the professions
• 2 Professions and social stratification
• 3 The cultural context of professions
• 4 Professions and the state
• 5 Patriarchy and the professions
• 6 Knowledge and the professions
• 7 A professional project - the case of accountancy
• Bibliography
• Author index
• Subject index