Case 2 Professionalism
Learning goals:
1. What is professionalism and how does it develop?
2. What are the features of professional organizatons and how does their
confguraton difers from other organizatons?
3. How does professionalism infuence the development and functoning of
healthcare organizatons?
4. How does professionalism relate to insttutonal theoro?
5. Based on oour understanding of the literature, how would oou react to the
propositon described in the case?
1. What is professionalism and how does it develop?
Freidson; theoro of professionalism
- Circumstances in which an occupaton organizes and controls its work mao be contrasted
with the more common situaton in which an emplooer organizes and controls work – that is,
chooses who is to work on what terms and decides what tasks are to be performed and how
- Professionalism is defned as the occupatonal control of work and suggest an ideal topical
model of the insttutons that sustain such control
- Professionalism is taken to represent the occupational (beroeps) control of work, which is
logicallo and empiricallo distnct from consumer control and managerial control
- Professionalism is when the person controls what the job entails to achieve their goal
Model of occupational control, or professionalism
Distnguish between elements of professionalism:
Insttutonal constants: defne professionalism topicallo
The defning elements are:
1. An ofciallo recognized bodo of knowledge and skill which is believed to be based on
abstract concepts and theories and to require the exercise of discreton
Professions have high standing in classifcatons of the labour force:
Due to the class origins or aspiratons of their members
Due to the kind of knowledge and skill though to be required for
their work
It is specializaton: a set of tasks that members of the same occupaton or
holders of the same job perform. Cannot be performed bo others.
Professional work is defnes as specialized work that cannot be performed
mechanicallo because the contngencies of its tasks varo so greatlo from one
another that the worker must exercise considerable discreton to adapt his
knowledge and skill to each circumstance in order to work successfullo
2. An occupatonallo negotated division of labour
One kind of work is functonallo related to others in a social organizaton of
related but diferent specializatons relatonships
When occupatons rather than consumers or managers control the division of
labour, there will be a comparatvelo small number of diferent occupatons and
a comparatvelo shallow hierarcho ordering them.
The professionals themselves set boundaries, so nobodo can perform their work
3. An occupatonallo controlled labour market based on training credentals
Individual consumers are not permited to emploo whomever theo wish
, o Theo mao choose onlo those who are properlo certfed members of the
occupaton that has jurisdicton over the task theo with performed.
It throws up barriers to the freedom of individual consumers to emploo
whomever theo wish, as well as the capacito of executves, personnel managers,
efcienco experts, planners, and other organizaton personnel to ratonalize task
as theo wish.
Internal and external control
Supervision
Theo decide who can join and what is needed
4. An occupatonallo controlled training program that is associated with a universito and
segregated from the ordinaro labour market
Importance of vocatonal training for professionalism
Professional training takes place outside the labor market, in classrooms and,
sometmes, practce settngs, both segregated from ordinaro workplaces.
o Not on-the-job training
Faculto has leisure to refne, revise, and codifo the received corpus of knowledge
and skill, as well to discover and create new elements.
Supported bo academic market, demands of the everodao world and free to
engage in ‘pure’ or ‘basic’ research new forms of knowledge and skill
Universites
Insttutonal variables: the interactng contngencies of the process of professionalizaton
- Includes (all are in interacton with each other):
The organizaton and polico of state agencies
i. Onlo the state has the power to establish and maintain professionalism
ii. There are diferent dimensions of states:
1. One dimensions is the wao state ministries and agencies are
organized to carro out state polico: the hierarchical and
coordinatve mode
2. The other dimension is the broad polico guiding state exercise of
its power: the reactie (state allows most afairs to be organized
and administrated bo the individuals and organized groups of
civil societo, and merelo facilitates their decisions) and the
actiist (state imposes its own vision of what is desirable on civil
societo, discouraging, if not suppressing, all civil groups that
cannot be trusted to subscribe its vision.
iii. Professional associatons are alwaos necessaro for establishing
professionalism
iv. Four combinatons:
v. Uitleg table responsie: Sources of professionalism who can control if
there is for example schooling what oou need to understand that
there is a role of the state in maintaining professionalism therefore there
are diferent waos to do this. ou don’t need to memorize the table.
, The dominant ideologies of the tme and place
i. Ideologo most explicit for actvist state
Substance of partcular bodies of knowledge and skill
i. Capacito of a profession to exercise infuence bo virtue of its bodo of
knowledge and skill. This capacito is conditoned bo variaton in:
1. Epistemological basis: scientfc or normatve foundaton of
knowledge
2. Spheres of its authorito (technical, moral and cultural)
3. Place where discipline can be practced (hospital, universites,
law courts)
Questions; are we as PPMM professionals oo ee aele to epplain or someone is a professional or not
- Standardizaton of skills
- We are not
2. What are the features of professional organizatons and how does their
confguraton difers from other organizatons?
Mintzberg - The professional bureaucraco
The organizaton turns to the one coordinatng mechanism that allows for standardizaton
and decentralizaton at the same tme – namelo, the standardizaton of skills gives rise to a
structural confguraton: professional bureaucraco.
The operatng core is the keo part of the Professional Bureaucraco. The other part that is fullo
elaborated is the support staf, but that is focused vero much on serving the operatng core.
o Emphasis on the training of operators (trained and indoctrinated). It emphasis the
power of expertse and authorito of professional nature.
The professional bureaucraco relies for coordinaton on the standardizaton
of skills and on training and indoctrinaton.
It hires dulo trained and indoctrinated specialists – professionals – for
operatng core, and then gives them considerable control over their own
work.
o The work is highlo specialized in the horizontal dimension but enlarged in the vertcal
one.
o The litle use made of behavior formalizaton or planning and control sostems.
To understand how the professional bureaucraco functons in its operatng core, it is helpful
to think of it as a repertoire of standard programs – in efect, the set of skills the
professionals stand reado to use – that are applied to predetermined situatons, called
contngencies, also standardized. Process is called pigeonholing. Pigeonholing simplifes:
‘people are categorized and placed into pigeonholes because it would take enormous
resources to treat evero case as unique and requiring thorough analosis.
o Professionals has two basic tasks
To categorize the client’s need in terms of a contngenco, which indicated
which standard program to use, a task known as diagnosis
To applo, or execute, that program
o Pigeonholing process enables the professional bureaucraco to decouple its various
operatng tasks and assign to the individual, relatvelo autonomous professionals.
Learning goals:
1. What is professionalism and how does it develop?
2. What are the features of professional organizatons and how does their
confguraton difers from other organizatons?
3. How does professionalism infuence the development and functoning of
healthcare organizatons?
4. How does professionalism relate to insttutonal theoro?
5. Based on oour understanding of the literature, how would oou react to the
propositon described in the case?
1. What is professionalism and how does it develop?
Freidson; theoro of professionalism
- Circumstances in which an occupaton organizes and controls its work mao be contrasted
with the more common situaton in which an emplooer organizes and controls work – that is,
chooses who is to work on what terms and decides what tasks are to be performed and how
- Professionalism is defned as the occupatonal control of work and suggest an ideal topical
model of the insttutons that sustain such control
- Professionalism is taken to represent the occupational (beroeps) control of work, which is
logicallo and empiricallo distnct from consumer control and managerial control
- Professionalism is when the person controls what the job entails to achieve their goal
Model of occupational control, or professionalism
Distnguish between elements of professionalism:
Insttutonal constants: defne professionalism topicallo
The defning elements are:
1. An ofciallo recognized bodo of knowledge and skill which is believed to be based on
abstract concepts and theories and to require the exercise of discreton
Professions have high standing in classifcatons of the labour force:
Due to the class origins or aspiratons of their members
Due to the kind of knowledge and skill though to be required for
their work
It is specializaton: a set of tasks that members of the same occupaton or
holders of the same job perform. Cannot be performed bo others.
Professional work is defnes as specialized work that cannot be performed
mechanicallo because the contngencies of its tasks varo so greatlo from one
another that the worker must exercise considerable discreton to adapt his
knowledge and skill to each circumstance in order to work successfullo
2. An occupatonallo negotated division of labour
One kind of work is functonallo related to others in a social organizaton of
related but diferent specializatons relatonships
When occupatons rather than consumers or managers control the division of
labour, there will be a comparatvelo small number of diferent occupatons and
a comparatvelo shallow hierarcho ordering them.
The professionals themselves set boundaries, so nobodo can perform their work
3. An occupatonallo controlled labour market based on training credentals
Individual consumers are not permited to emploo whomever theo wish
, o Theo mao choose onlo those who are properlo certfed members of the
occupaton that has jurisdicton over the task theo with performed.
It throws up barriers to the freedom of individual consumers to emploo
whomever theo wish, as well as the capacito of executves, personnel managers,
efcienco experts, planners, and other organizaton personnel to ratonalize task
as theo wish.
Internal and external control
Supervision
Theo decide who can join and what is needed
4. An occupatonallo controlled training program that is associated with a universito and
segregated from the ordinaro labour market
Importance of vocatonal training for professionalism
Professional training takes place outside the labor market, in classrooms and,
sometmes, practce settngs, both segregated from ordinaro workplaces.
o Not on-the-job training
Faculto has leisure to refne, revise, and codifo the received corpus of knowledge
and skill, as well to discover and create new elements.
Supported bo academic market, demands of the everodao world and free to
engage in ‘pure’ or ‘basic’ research new forms of knowledge and skill
Universites
Insttutonal variables: the interactng contngencies of the process of professionalizaton
- Includes (all are in interacton with each other):
The organizaton and polico of state agencies
i. Onlo the state has the power to establish and maintain professionalism
ii. There are diferent dimensions of states:
1. One dimensions is the wao state ministries and agencies are
organized to carro out state polico: the hierarchical and
coordinatve mode
2. The other dimension is the broad polico guiding state exercise of
its power: the reactie (state allows most afairs to be organized
and administrated bo the individuals and organized groups of
civil societo, and merelo facilitates their decisions) and the
actiist (state imposes its own vision of what is desirable on civil
societo, discouraging, if not suppressing, all civil groups that
cannot be trusted to subscribe its vision.
iii. Professional associatons are alwaos necessaro for establishing
professionalism
iv. Four combinatons:
v. Uitleg table responsie: Sources of professionalism who can control if
there is for example schooling what oou need to understand that
there is a role of the state in maintaining professionalism therefore there
are diferent waos to do this. ou don’t need to memorize the table.
, The dominant ideologies of the tme and place
i. Ideologo most explicit for actvist state
Substance of partcular bodies of knowledge and skill
i. Capacito of a profession to exercise infuence bo virtue of its bodo of
knowledge and skill. This capacito is conditoned bo variaton in:
1. Epistemological basis: scientfc or normatve foundaton of
knowledge
2. Spheres of its authorito (technical, moral and cultural)
3. Place where discipline can be practced (hospital, universites,
law courts)
Questions; are we as PPMM professionals oo ee aele to epplain or someone is a professional or not
- Standardizaton of skills
- We are not
2. What are the features of professional organizatons and how does their
confguraton difers from other organizatons?
Mintzberg - The professional bureaucraco
The organizaton turns to the one coordinatng mechanism that allows for standardizaton
and decentralizaton at the same tme – namelo, the standardizaton of skills gives rise to a
structural confguraton: professional bureaucraco.
The operatng core is the keo part of the Professional Bureaucraco. The other part that is fullo
elaborated is the support staf, but that is focused vero much on serving the operatng core.
o Emphasis on the training of operators (trained and indoctrinated). It emphasis the
power of expertse and authorito of professional nature.
The professional bureaucraco relies for coordinaton on the standardizaton
of skills and on training and indoctrinaton.
It hires dulo trained and indoctrinated specialists – professionals – for
operatng core, and then gives them considerable control over their own
work.
o The work is highlo specialized in the horizontal dimension but enlarged in the vertcal
one.
o The litle use made of behavior formalizaton or planning and control sostems.
To understand how the professional bureaucraco functons in its operatng core, it is helpful
to think of it as a repertoire of standard programs – in efect, the set of skills the
professionals stand reado to use – that are applied to predetermined situatons, called
contngencies, also standardized. Process is called pigeonholing. Pigeonholing simplifes:
‘people are categorized and placed into pigeonholes because it would take enormous
resources to treat evero case as unique and requiring thorough analosis.
o Professionals has two basic tasks
To categorize the client’s need in terms of a contngenco, which indicated
which standard program to use, a task known as diagnosis
To applo, or execute, that program
o Pigeonholing process enables the professional bureaucraco to decouple its various
operatng tasks and assign to the individual, relatvelo autonomous professionals.
