Eliot Freidson


Copyright © Eliot Freidson 2001

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Part I Professionalism: The Ideal Type

1    Professional Knowledge and Skill

2    Divisions of Labor

3    Labor Markets and Careers

4    Training Programs

5    Ideologies

Part II The Contingencies of Professionalism

6    States and Associations

7    Bodies of Knowledge

Part III The Fate of Specialized Knowledge

8    The Assault on Professionalism

9    The Soul of Professionalism




The epigraph of this book expresses my sense of inadequacy in writing it, for now the doughy mass of print which frustrated Qfwfq is even larger, more doughy, and more indigestible than ever before. The logic of my enterprise required me to deal with a number of areas in which I am not a specialist, areas which I had to sample rather than command, and sampling, as we all know, is a risky business. I am burdened, as Max Weber (1946b: 134–5) put it, “with the resigned realization that at best one provides the specialist with useful questions upon which he would not so easily hit from his own specialized point of view. One’s own work must inevitably remain highly imperfect.” Furthermore, I am aware that much of what I write here is not really new, for I have used many of the insights of the admirable scholars of the past who have suffered the bittersweet success of having been so fully absorbed into the way we think today that we forget them as our sources. For all that, my hope is that I have presented the familiar from a different angle which can give a fresh perspective to the old, perhaps insoluble problem of the place of knowledge and skill in human life.

This book was part of a larger project on which I have worked sporadically over a fairly long period of time. It has certainly been influenced by the many informal verbal encounters that are the lifeblood of collegiality but which are unfortunately difficult to remember. Some of the content of those encounters has certainly found its way into this book, although I can only acknowledge the help of colleagues who must remain anonymous. On a more formal level, I had occasion to consult colleagues who read andcommented on early drafts of one chapter or another. I acknowledge with gratitude the helpful comments and suggestions that I received from Robert Althauser, Thomas Bender, Michael Burrage, Burton Clark, Frederic Hafferty, Barbara Heyns, Burkhart Holzner, Caroline Persell, Seymour Spilerman, Anselm Strauss, and Dennis Wrong.

An even greater debt of gratitude is owed to those who read the penultimate draft of this book and made many useful critical comments and suggestions. They are Howard S. Becker, Steven Brint, Robert Dingwall, Magalí S. Larson, and Derek L. Phillips. Robert R. Alford went far beyond the call of duty in the detail of his comments and was especially helpful. None of those I consulted should be held responsible for any of the flaws in this book, if only because their recommendations led me more often to try to clarify my analysis than change it.

Some of this book was written while I was Scholar in Residence in the pleasant and stimulating surroundings of the Villa Serbelloni in Bellaggio, whose hospitality is gratefully acknowledged. I must also express gratitude to the European University Institute (Fiesole) for its subsequent hospitality, and for the more recent scholarly aid provided by the Department of Sociology, University of California, Berkeley, where I was Visiting Scholar, and the Department of Social and Behavioral Sciences, University of California, San Francisco, where I have been Visiting Professor.

Finally, I must say that whatever clarity this book possesses stems from the meticulous and expert editing of my wife, Helen Giambruni, to whom I dedicate this book with love and gratitude.

San Francisco

ixAnd I think how beautiful it was then, through that void, to draw lines and parabolas, pick out the precise point, the intersection between space and time where the event would spring forth, undeniable in the prominence of its glow; whereas now events come flowing down without interruption, like cement being poured, one column next to the other, one within the other, separated by black and incongruous headlines, legible in many ways but intrinsically illegible, a doughy mass of events without focus or direction, which surrounds, submerges, crushes all reasoning.

(from “How Much Shall We Bet?”, in Cosmicomics,
by Italo Calvino)


Imagine a world in which we are all free to buy and sell anything we choose, individually competing with each other to buy at the lowest possible price and sell for the highest possible price. Nothing is regulated nor are there any large companies or unions to limit that competition. Such free and unregulated competition both encourages innovation, which increases the variety and quality of goods and services, and keeps prices down. Consumers are fully informed about the quality and cost of available goods and services and choose them rationally, to their own best interest. This world is organized around consumption, with consumer preference and choice determining whose services will succeed. Value is measured primarily by cost.

Now imagine a different world in which the production and distribution of goods and services are planned and controlled by the administration of large organizations. Each organization, whether a private firm or a public agency, is governed by an elaborate set of rules that establish the qualifications of those who can be employed to perform different jobs and that define their duties. The effective planning and supervision of a variety of specialized jobs standardizes production so as to assure consumers of reliable products at a reasonable cost. In this world, the executive officers or managers of organizations control those who produce goods and services, aiming primarily at predictability and efficiency.

Finally, imagine a world in which those workers who have the specialized knowledge that allows them to provide especially important services have the power to organize and control their own work. Legally, only they can offer their particular services to consumers or hold jobs performing them in organizations: neither consumers nor managers are free to employ anyone else. Furthermore, only members of the occupation have the right to supervise and correct the work of colleagues. They do not abuse those exclusive rights, however, because they are more dedicated to doing good work for their own satisfaction and for the benefit of others than to maximizing their income. Thus, consumers and managers can count on work of high quality at reasonable cost.

All three of these are pipe-dreams, of course. None of those worlds exists, and where some of their elements have existed, predicted virtues are always accompanied by unanticipated vices. In unregulated markets, consumers must contend with deception, fraud, and collusion to inflate prices. In organizations, there is inflexibility and perfunctory treatment of consumers. And when occupations are in charge, their members may put economic advantage ahead of the good of their clients. Nonetheless, faith in those imagined worlds, each operating from a different set of assumptions, lies behind policy choices. They represent three logics. But while two of them are quite familiar and well worked out in theory, the third, which I call professionalism, is not. In this book I will spell out that third logic, showing it to be a set of interconnected institutions providing the economic support and social organization that sustains the occupational control of work. I will do so by systematically contrasting it with the other two, more familiar logics, treating all three as pipe-dreams or, put more academically, as ideal types. The ideal type is a method of conceptualization that can both organize the abstract theoretical issues which concern scholars and highlight the practical issues confronting social policy.

A Question of Policy

The policy issue that concerns me in this book is the status of professions in advanced industrial society. For decades now, the popular watchwords driving policy formation have been “competition” and “efficiency,” the first referring to competition in a free market, and the second to the benefits of the skilled management of firms. Those watchwords are being invoked in aggressive campaigns to change profoundly the governing and staffing of schools and universities, health, welfare, legal, and other institutions in which professionals perform key functions. Until recently those institutions and the professionals who work in them occupied a specially protected position. Now, especially in the United States but also elsewhere, their position is being seriously weakened in the name of competition and efficiency. It is charged that professions have monopolies which they use primarily to advance their selfish economic interests while failing to insure benefit to consumers, that they are inefficient, their work unreliable and unnecessarily costly. Strip away their protective licenses and credentials, urge some, and let there be truly free competition. Open the market to all who wish to offer their services. Consumers will separate the wheat from the chaff in such a market so that the best services and products will emerge at the lowest cost. Where services are complex, requiring the coordination of many specialists and expensive technology, as is the case for medicine, let them be organized by firms whose managers are devoted to efficiency. Then let the firms compete with each other for consumer choice.

In response, the professions have not defended themselves well. For one thing, as Brint (1994) has shown, they are divided. They are a varied collection of occupations working in different sectors of the economy and with different vested interests, more inclined to attack each other than to recognize that they all share the same basic institutional arrangements. Then when they do defend themselves they rely primarily on a rhetoric of good intentions which is belied by the patently self-interested character of many of their activities. What they almost never do is spell out the principles underlying the institutions that organize and support the way they do their work and take active responsibility for their realization.

These principles differ markedly from those of the market, which celebrates competition and cost, and from those of the firm, which invokes the virtue of efficiency through standardization. I will show in this book that monopoly is essential to professionalism, which directly opposes it to the logic of competition in a free market. Freedom of judgment or discretion in performing work is also intrinsic to professionalism, which directly contradicts the managerial notion that efficiency is gained by minimizing discretion. Those defending their professions have failed to defend those head-on contradictions as essential parts of a larger whole whose logic and outcome are distinctly different from those of the market and the management of firms and which cannot be eliminated without seriously damaging the whole. In this book I will show in some detail how the properties of professionalism fit together to form a whole that differs systematically from the free market on the one hand, and the firm, or bureaucracy,1 on the other. Only when that difference is established will I finally evaluate the consequences of excessive emphasis on competition and efficiency in professional work.

My Analytic Strategy

In my last sustained work (Freidson 1986), I presented a detailed analytic description of the institutions supporting professions in the United States toward the end of the third quarter of the twentieth century. In this book, my central concern is quite different. It is not to describe what exists in a particular time and place but to present a model of the logic of professionalism that can enjoy the same privileged intellectual status as the logics of the market and the firm. I will first establish the basic institutional characteristics of ideal-typical professionalism and then analyze the circumstances which make those characteristics possible. In adopting this strategy, I have chosen not to follow the example of traditional scholarly discussions about professions, which are largely inductive, seeking to find a general pattern or “essence” of professionalism in the variety of occupations called professions in various times and places. The patterns found by this method are necessarily circumscribed by the concrete cases studied so that, for example, many students of Anglo-American professions have mistakenly emphasized formal codes of ethics and private associations as essential institutions for occupations to gain professional status. Furthermore, because scholars do not share the same analytic framework, the information that one collects and analyzes may be overlooked by another so that their analyses are incomparable. Thus, while the literature on professions has burgeoned over the past few decades, with studies being made of previously unexamined occupations, historic periods, and nations, conceptualization has been scattered and typologies have proliferated to the point of confusion. Instead of building a sturdy tower of knowledge, this activity has created a number of scattered huts, some very elegant indeed, but huts nonetheless. It is the use of the inductive method that is responsible for this outcome.

I hold that a logical model based on a theoretically chosen foundation can provide focus and direction to empirical studies, at the very least by serving as a clear target for criticism and revision. Furthermore, if constructed systematically, a logical model can have the comprehensiveness that generalizations from limited empirical cases lack. The model I propose is general and grounded in the world of work, most particularly in the political and economic institutions by which workers gain their living. It assumes that the historic professions are occupations and that because, like all occupations, they cannot exist without some way of gaining an income, their position in the marketplace is the most appropriate foundation on which to erect a model. I further assume that the historic professions and crafts exemplify to a greater or lesser degree, though none completely, a circumstance in which occupations themselves rather than consumers or managers control work. It is this possibility that I will develop systematically as an ideal type, informed but not limited by what I have learned about some historic professions and crafts. In order to clarify and dramatize the characteristics of this third logic, I will compare them with those postulated for the ideal-typical free labor market and the ideal-typical rational-legal bureaucracy.2 While the model I present is static, and cannot therefore reflect the real world of process and change, it has the considerable virtue of being able to provide a stable point against which empirical variation and process can be systematically compared and analyzed. Provided one never forgets that it is solely an intellectual tool, a heuristic device, and not an effort to portray the varied reality of professions and crafts in different times and places, it can be as useful as the more familiar theoretical constructs of the free market and rational-legal bureaucracy which are similarly abstracted from reality.

My theoretical approach is different from that of Larson (1977) and Abbott (1988), two of the most influential analysts of the professions over the past few decades on whose work I have drawn heavily. Larson constructs a historic narrative around the process by which a limited group of occupations in England and the United States undertook to raise their social status (collective mobility) and gain a monopoly in the marketplace (the market project). She studies the historic process of professionalization, emphasizing how economic advantage for occupations is attained by restricting the supply of practitioners and striving for a special position of public respect and influence. In so far as her narrative is explicitly concerned with the historic development of the professions, and is linked to the broader literature of Marxist and Weberian theory, it has proven to be a very influential resource for historians as well as sociologists. However, it does not develop the logic of the concepts it suggests because they are developed within a limited historic framework. Unlike Larson, I shall not concentrate on analyzing the rise (or decline) of the historic professions. While I rely on many of her concepts and insights, I abstract them into a model of interconnected institutions whose realization depends upon the conjunction of a limited number of contingencies.

I also rely on much in Abbott’s tour de force for my analysis, but I do not choose to employ his method. He does not postulate a specific process of professionalization as does Larson; rather, he expresses skepticism about the very possibility of discovering one. He analyzes instead the process by which occupations gain, maintain, adjust, and even lose their exclusive jurisdiction over particular tasks and the critical, largely functional factors involved in that process. His focus is primarily on the relation of occupations to each other in a division of labor, with the forces influencing their jurisdictional boundaries establishing their official and social identities as well as their economic fortunes. He does discuss the social, economic, and symbolic sources of challenge and support, as well as the significance of an occupation’s particular body of knowledge, but his concentration on jurisdiction leads him well past the conventionally defined professions to include many specialists who have attained considerably less privilege, leaving the question of their status open. More importantly, although he offers a rich and imaginative analysis of the institutions connected with occupational jurisdictions, his method is idiosyncratic, embodying neither a clearly structured analytic procedure that others can emulate and refine, nor explicit connection to other bodies of data and theory that have been important for the analysis of work and employment.

By its very nature, my analysis cannot be as rich as Abbott’s or Larson’s. Its intent is to erect a systematic framework around the substantive processes that concern them both – the processes connected with establishing and maintaining jurisdiction as well as with establishing and maintaining a privileged position in the labor market. My intent is to create a logic, a systematic way of thinking that can embrace and order most of the issues with which they deal, and to demonstrate how that logic represents a third approach to understanding how work can be organized and controlled. These different approaches will be discussed in detail in the chapters that follow.

Structure and Process

Narrative history limns process, as does any other description which attempts to be faithful to human affairs. But the ideal type that I advance establishes structure, which is fixed and static. How can this be justified? It is its very fixity that allows an abstract model to serve as an unchanging point against which one can compare and sort out the constantly changing empirical world. This is comparable to the commonsense strategy of everyday life that allows us to understand and describe the variety of the creatures we call dogs by comparing all of them against an intuitive model of “dog;” Linnaeus and his taxonomist descendants use more refined criteria but employ essentially the same method.

Such a method allows us to point and classify. It does not, however, allow us to understand how deviations from the fixed model come to be, why some occupations in some times and places succeed or fail to resemble the model. That is why the second part of my analysis is essential. It describes and analyzes the institutions and circumstances which can advance or impede the development or maintenance of the political and economic status of occupations and their control over their work. They represent the contingencies of professionalization which vary with the concrete contexts of time, place, and industry or economic sector, and which interact with each other. While the model hangs together by virtue of its own consistency and logic, providing a stable point for imaginative comparison with the real world of time and place, the contingencies of professionalism provide the resources for analytic description of how particular occupations in particular times and places come to resemble the model and be called professions or, conversely, lose all resemblance to it and become on the one hand mere casual labor in a spot market controlled by consumers, or on the other, mere job-holders in firms controlled by managers.

Ideal Types and Reality

How helpful is it to postulate a fixed model by which to analyze the variety of occupations to be found in different times and places? Think of Adam Smith’s conception of the free market. Certainly no one can question its enormous value to the discipline of economics even though it does not accurately portray the vast majority of markets anywhere in the real world and never did. It is enough for analysts that the elements of the model are present in one way or another, however grievously distorted by circumstance. If successful, the model’s simplicity is strategic. It allows one to engage in systematic reasoning from its conditions to the varying circumstances of the real world and it can be grasped sufficiently well to be reasoned from.

The same is true of the ideal-typical model of rational-legal bureaucracy advanced by Max Weber. It is quite different from Smith’s model, more structural and less abstract. It was initially formulated to make sense of a particular method of organizing and exercising authority over the conduct of state affairs, a method which displaces administrative structures organized around various forms of traditional authority or around charismatic authority. It was patently inspired by the state civil service of Imperial Germany. Weber did not make much use of his model to analyze the governance and administration of industrial or other economic firms, but the marks of his model are clear in the theories of management or administration by which scholars began to analyze business firms early in the twentieth century (see Massie 1965 and especially Perrow 1986) and always forms part of the background of present-day analyses of firms and “internal labor markets.”

Nonetheless, virtually since its formulation many have demonstrated that the formal organizations of the empirical world often deviate markedly from Weber’s model. Furthermore, during the course of this century but particularly over these last two decades, a number of scholars have asserted that changes in managerial practices, technology, and the environment of firms have been so profound that the fundamental bureaucratic principle of hierarchical control realized by formal supervisory and personnel policies has been displaced by new forms of organization and employment. For example, it has been claimed that open systems and even dynamic loose networks are displacing formal, hierarchical organizations.3

The degree to which fundamental changes have actually taken place and, if so, will be permanent rather than transitory, is of course open to question. Whatever the case, in the very expositions arguing such changes, the baseline, the foil, the organized point of comparison for delineating what is different about those new forms of organization remains Weber’s ideal type or its reflection in traditional management conceptions of formal organization. Its coherence and intuitive sense are what give it value, not its faithfulness to transient events. It is no accident that it has survived so long while other, more processual and empirically accurate conceptions litter the dustbin of history. The ideal type provides a disciplined focus for the imagination when confronted by the variety of the world even after the world has changed so much that little of the model remains to be observed.

The same might be said about an ideal type portraying organization and control of work by occupation rather than by market or hierarchy. It can be intellectually useful even if present-day professions, crushed between private capital and the state, may be losing their special economic and social position as Krause (1996) claims, or if the “organizational [rather than occupational] dominance of expertise” will emerge, as Abbott (1991b: 39) believes. There are even more extreme predictions that occupations as such will disappear in a “postmodern” economy, and that jobs will be composed of “flexible skills” rather than clearly defined tasks. Casey (1995) goes so far as to project a “post-occupational” society. There are good grounds to question how both specialization and relatively stable occupational identities and careers can actually be eliminated,4 but even if this is to be the case, the logical as well as historic importance of such organized occupations as crafts and professions justifies our attention.


In conclusion, I must note that I have more than one purpose in this book and that these purposes are likely to interest different audiences. This poses some difficulty for my exposition. First, as much of my discussion indicates, I address the scholarly audience of Anglo-American and European historians, sociologists, and political scientists who have studied and theorized about the professions over the past thirty or forty years. For them, my main concern is to present a framework that might clarify and organize their work. In addition, I hope to call their attention to the broader field of the sociology of work, where studies of the professions belong. With but few exceptions, the study of professions has been in an intellectual world of its own, completely separated from studies of more humble occupations, from long-standing and sophisticated studies of industrial organization, and from recent work on labor markets and status attainment. In the empirical study of some professions, engineering being the most obvious example because its work is often carried on in industrial plants, attention to such literature is essential. However, the study of all professions can benefit considerably from greater familiarity with the more catholic concepts and illuminating data to be found in the sociology of work. By referring to and sometimes discussing key studies in those fields, I hope to draw the attention of my colleagues who study the professions to the broader intellectual context that I believe our field needs.

Second, I hope that my effort to connect the study of professions to industrial, labor force, and labor market studies may stimulate specialists in those areas to pay closer attention to the systematic analysis of occupations, of which professions are the most well organized. It is common in a number of areas to distinguish three basic kinds of employment relations. In labor market studies, for example, three types of labor market are distinguished: secondary, or open labor market, which refers to the classic external free market; firm internal labor market, which refers to firms or bureaucracies; and occupational labor market, which refers to occupational control of employment relations. Occupation is almost always recognized as a distinct and separate basis for regulating employment and work. And in political analysis, Streeck and Schmitter (1985) argue that “association” or “interest group,” and most particularly occupational association, must be added to state, market, and community as the fourth basic source of social order.5 But in spite of widespread recognition of occupation as a basic political, economic, and social category, it has not received the same amount of analytic attention as have market and firm, nor has it been elaborated systematically. It has largely been used as an indicator of something else – of class, education, status, or income. I hope that the ideal type I develop here may stimulate the development of systematic ways of analyzing jobs and occupations, not solely through occupational labor markets, but also through ways of organizing divisions of labor and educational systems.

Finally, I address those concerned with forging public policy dealing with the financing and governance of the legal, medical, educational, and other institutions in which professionals work. For that audience, my exposition is much different than most in that instead of discussing public policy issues directly, I present a systematic analysis of the rationale underlying policies upon which professionalism depends. I try to clarify and dramatize that rationale by comparing it to those which are quite different and intrinsically hostile to professionalism. Advocates of the market and of bureaucratic management treat professionalism as an aberration rather than something with a logic and an integrity of its own. I hope that my extended comparison of the institutions of professionalism with those represented by the attractive watchwords of competition and efficiency may help guide debate through the doughy mass of contemporary rhetoric that obscures the basic issues underlying policy. But since the early chapters must of necessity discuss fairly abstract, perhaps excessively academic matters in order to establish the basic differences of the three logics, readers more interested in policy may find it more interesting to begin with chapter 4.

For that audience I must also note that while I conclude this book with a discussion of professional ethics, my emphasis will not be on the behavior of individual professionals. This is not because I do not consider individual ethics important for the performance of all kinds of work, but because I believe that the economic, political, and social institutions which permit, even actively encourage, ethical behavior are ultimately more important. Even when those called professionals are something more than average people, few can be immune to the constraints surrounding the work they do. It is the institutional ethics of professionalism that establishes the criteria by which to evaluate those constraints. If the institutions surrounding them fail in support, only the most heroic individuals can actively concern themselves with the ethical issues raised by their work. Professionalism requires attention to the ethical status of those institutions.

The Plan of this Book

A note about terminology before I outline the chapters to follow. I use the word “professionalism” to refer to the institutional circumstances in which the members of occupations rather than consumers or managers control work. “Market” refers to those circumstances in which consumers control the work people do, and “bureaucracy” to those in which managers are in control. Professionalism may be said to exist when an organized occupation gains the power to determine who is qualified to perform a defined set of tasks, to prevent all others from performing that work, and to control the criteria by which to evaluate performance. In the case of professionalism, neither individual buyers of labor in the market nor the managers of bureaucratic firms have the right to themselves choose workers to perform particular tasks or evaluate their work except within the limits specified by the occupation. The organized occupation creates the circumstances under which its members are free of control by those who employ them.

While few if any occupations can be said to fully control their own work, those that come close are called “professions” in English. A word for occupations meeting that criterion is not common in other languages, though “profession” has been adopted in some. To complicate matters further, even in English the word has other meanings as, for example, Bledstein (1985) and especially Kimball (1992) show. The most rational method of dealing with this problem might be to avoid using the word entirely, but because neologisms have rarely been successful, I feel I have no choice but to use it. Still, wherever I can, I try to use “occupation” instead of “profession” in order to avoid the pretentious, sometimes sanctimonious overtones associated with the latter. As Everett Hughes (1971: 417) emphasized, “We need to rid ourselves of any concepts which keep us from seeing that the essential problems of men at work are the same whether they do their work in the laboratories of some famous institution or in the messiest vat room of a pickle factory.” The concept of profession tends to keep us from seeing those with that label as workers. It does properly signal that they have a special position in the political economy which truly distinguishes them and the problems they have at work from those in other occupations. But it obscures with the fog of mystique much of what they have in common with more humble occupations, exaggerating their differences. It is primarily the logic I have chosen that leads me to put the economic and political foundation of work first, but doing so is also an effort to avoid that mystique by secularizing the issues.

In part I of this book I present the ideal type, professionalism. Chapter 1 provides a context for analyzing its mode of controlling work by portraying the broad range of knowledge and skill within which the special kind of knowledge ascribed to professionalism is to be found, knowledge believed to require the exercise of discretionary judgment and a grounding in abstract theory and concepts. Occupations believed to possess such knowledge are singled out for the public prestige and official privilege in the marketplace which are essential to what, in English-speaking nations, are called professions. Chapter 2 portrays three profoundly different ways by which the relations between specializations composing a division of labor can be organized. In the ideal-typical case of professionalism, occupations have the power to negotiate their jurisdictions with each other. This produces a markedly different outcome in the content and organization of their division of labor than would be the case in a free or a bureaucratically controlled division of labor – the degree of specialization, for example, and the hierarchical relations between occupations. My discussion of those systematic differences continues in chapter 3, where I address the ways entrance into labor markets and subsequent work careers vary as the source of control varies. I note that in each case there are characteristic differences in career-line and both vertical and horizontal mobility. And since it is characteristic of occupational control of the labor market that eligibility for work is determined by training credentials produced by the occupation itself, I am brought to examine more closely in chapter 4 the ideal-typical characteristics of the training institutions of professionalism and their implications for both the development and control of new knowledge and skill and for stratification within occupations. This leads to discussion in chapter 5 of the ideology of professionalism, comparing it with those which advance the logic of the market and of bureaucracy.

In part II I analyze the major institutional contingencies of professionalism – the circumstances that vary historically and nationally and that have critical bearing on the process by which occupations gain special status in the labor force, control the division of labor and the labor markets in which they work, and the way their members are trained. Chapter 6 discusses the consequences of variation in the organization and policy orientation (or political ideology) of the state, and in the organization of occupations themselves. Chapter 7 explores the way the substantive characteristics of different bodies of knowledge and skill pose requirements for successful practice that in turn influence the occupation’s capacity to attain professional privilege.

Finally, in part III, I turn to evaluating professionalism empirically in light of the criticism and economic and political pressures to which it has been subjected in recent years. In chapter 8, I briefly summarize the ideal type and its contingencies, then give a practical demonstration of its use by analyzing the changing status of the profession of medicine in the United States. This is followed by a discussion of the direction that public policy toward professions has been taking in advanced industrial nations in Europe and the United States, influenced as much by ideology as by functional necessity. I conclude this book in chapter 9, where I show that the most conspicuous attacks on professionalism are largely empty rhetoric which fails to address the central question of how the development and practice of specialized knowledge and skill should be organized and controlled. After suggesting how professional work may be subordinated to the immediate needs of both capital and the state in the future, I note that this will not put at serious risk the economic and political institutions supporting the special status of professions. What is at risk today, and likely to be at greater risk tomorrow, is the independence of professions to choose the direction of the development of their knowledge and the uses to which it is put.

1 My usage oscillates between “firm” and “rational-legal bureaucracy” because the former term, whose virtue is that it is familiar to everyone and has no invidious connotations, generally refers solely to private corporations in capitalist societies. However, I mean to refer to all formal organizations which exemplify the managerial control of work, including the state civil service agencies that are often called bureaucracies, and I rely on Max Weber’s ideal-type, rational-legal bureaucracy for my model of firms.

2 Some of these comparisons are likely to seem elementary to the specialist, but they are essential for demonstrating to others the systematic differences between the three models.

3 See, for example, Kalleberg 1996, and the papers in Littek and Charles 1995. For a systematic review and appraisal of new forms of industrial organization and the claims made for them, see Smith 1997 and Tomaney 1994. For networks as neither hierarchy nor market, see Powell 1990.

4 The issue of flexible or multiple skills is put into perspective by noting that the phenomenon represents the reconfiguration of related skills into new jobs or occupational titles which can become stable either in a firm or across firms as an occupation. Outside of Marx’s fantasy of a future communist society in which no one’s potential is limited by specializing in one kind of work, a bundle of multiple skills cannot be composed of just any collection of tasks, from parking cars to programming a computer to lecturing on quantum theory and playing viola in a piano quintet. Those flexible skills must be related to each other. Furthermore, if firms no longer offer lifelong careers of internal promotion, salary increments, and pension plans, workers must participate in what Sabel (1995) calls an open labor market, where occupational rather than firm identity becomes essential for work careers. Casey’s prediction is based on ignoring how those who left the firm she studied got another job elsewhere without using either their educational credentials or a transferable job description.

5 Indeed, it could be argued that in the present day occupation takes on the characteristics of community. This is of course the position of Durkheim’s classic work (1964), revived in a much more sophisticated form in Grusky and Sørensen 1998. The latter note the present-day exhaustion of class theory and suggest that “disaggregating” class into component occupations might solve what have come to seem insoluble problems. They point to the fact that occupation, not class, provides social identity, and that especially in the case of professions and crafts it forms the basis for organized activities.

Part I

The Ideal Type


Professional Knowledge
and Skill

In the most elementary sense, professionalism is a set of institutions which permit the members of an occupation to make a living while controlling their own work.1 That is a position of considerable privilege. It cannot exist unless it is believed that the particular tasks they perform are so different from those of most workers that self-control is essential. There are other important ways of evaluating work which I shall discuss in later chapters, but here I want to establish the essential framework of distinctions that defines the type of knowledge and skill at the core of professionalism. The two most general ideas underlying professionalism are the belief that certain work is so specialized as to be inaccessible to those lacking the required training and experience, and the belief that it cannot be standardized, rationalized or, as Abbott (1991b: 22) puts it, “commodified.” These distinctions are at the foundation of the social processes which establish the social and economic status of professional work, and while they are elementary, they are too important to take for granted. Here and in the next chapter I will analyze the technical and social assumptions employed in distinguishing different kinds of work with the aim of defining the particular kind of knowledge which is granted the social and economic privileges required for the institutions of professionalism.2

The Growth of Specializations

Specialization – the use of a circumscribed body of knowledge and skills thought to gain particular productive ends – is inherent in work, for it is rare that individuals are either able or willing to perform all of the tasks required for producing the food, shelter, and clothing they need for survival, let alone the amenities of life. After all, even Robinson Crusoe finally had his Friday. And since people do different kinds of work, it follows that they will be evaluated in some way or another. The degree and kind of specialization required by particular jobs, quite apart from their function, is widely used to establish their social, symbolic, and economic value and justify the degree of privilege and trust to which they are entitled.

Some degree of specialization in the work that people do is probably generic to social life. Most writers today believe that gender has been a universal basis for organizing specialization in human societies, even the most ancient, and that there has always been some specialization based on age as well, with children performing some kinds of tasks, adults others, and the aged still others. These rudimentary (but fluid) axes of age and gender upon which specialization has probably always and everywhere been based, order the various work roles that individuals adopt during the course of their daily lives in households and communities. But in daily life people perform a number of different tasks, each having different productive aims and requiring different skills. That is very different from my concern here, which is occupational specialization: people performing only the bundle of tasks connected with a defined productive end in an occupation.

When this narrower range of specialization becomes the source of a living, its practitioners are dependent on more than family or immediate community to provide them with the resources by which they can live. Should they specialize only in producing food, they need to enter into exchange relations with people who can provide them with everything else they need. They may specialize more narrowly – producing only one kind of food, for example, or, like the miller of grains, only processing food, or even, like the shaman, witch doctor, or priest, performing activities having no direct connection with material subsistence. Each additional degree of specialization increases the complexity of the exchange relationships needed to gain the resources for a living.

Full-time specialized work is generally thought to have become common first in the large, dense settlements of the early high civilizations of the Middle East, the Indus Valley, the Far East, and Central and South America (Childe 1965). There, those who performed particular tasks developed distinct and stable social identities as “trades,” many of which are still familiar to us today. In general, the convention is to characterize such trades as being specialized in producing a single product or service as a whole, from the beginning to the point where it is ready to be consumed. So one can speak of shoemakers, potters, bakers, and the like. But by the end of the eighteenth century in England, most particularly during the nineteenth century in England, western Europe, and North America, and elsewhere not until the twentieth century, the Industrial Revolution created a new kind of specialization. Adam Smith was its best-known early celebrant.

Manual Specializations

In The Wealth of Nations, published in 1776, Smith’s very first chapter began with praise for the way specialization increased productivity. He was not referring to the traditional trades, though they are certainly specialized. He wrote about a much less traditional form with which his vocabulary could not deal adequately. As the nouns “specialist” and “specialization” were not available in English before the middle of the nineteenth century nor in French before 1830 (OED 1971: 2948; Robert 1978: 1851) Smith used the phrase “division of labor” instead, and characterized the specialized enterprises of the workers he discussed as “trades,” even though they were not defined as occupations. This new kind of specialization was exemplified by Smith’s discussion of pinmaking, where the conventional, recognizable trade of pinmaker was replaced by a number of smaller and narrower, highly repetitive jobs created by assembling a number of workers under one roof and having each specialize in one of the separate tasks that together are employed to make a pin. Some workers devoted themselves to drawing out the wire, others to straightening it, still others to cutting it, or pointing it, or grinding it at the top for receiving the head. Some made the heads, others fastened the heads to the pins, others whitened the pins, and still others put the completed pins into a paper.

By means of this kind of specialization, the occupation of pinmaker is broken down into separate, limited tasks, each part of a coordinated plan designed to result in the production of pins. Thus, the pinmaker is no longer an individual practicing a trade; the organization and its production plan become the pinmaker, and each of the tasks created by the plan becomes so narrow in scope and simple and repetitive in execution that outside the organization it is unrecognized as a trade or an occupation. It is seen only as a job or as work within the pinmaking establishment. Neither in general official statistics nor in everyday life do those jobs gain social identities based on the particular specializations of wire-straightening, pin-head making, pin whitening, and the like, though in detailed labor statistics they might be so distinguished. Outside the firm, both officially and in everyday life, the primary social identity of those who perform such jobs lies in being an unskilled or semi-skilled industrial worker, or in being an employee of a particular firm, identified by working at the firm rather than by the specific job in that firm. The work is not defined or organized as an occupation.

This form of specialization was not entirely new for the Industrial Revolution. In the fourth century BC, Xenophon described a range of specializations at the end of which there was something “less than a whole trade” that resembled what Smith described: