Professional Work

Sociological Theory and Professional Work

Early- and mid-20th-century theory focused on defining professional work using sets of traits (such as credentials, codes of ethics, ties to science, or knowledge mastery). However, the list of traits varied widely, and the relationships between the traits and larger organizational and institutional forces were not well specified.

The prevailing movement in the 1970s and 1980s was toward models of professional organizations and knowledge claims. These new models of professions and professional practice moved beyond the conception of professional work as a rational, goal-oriented system toward organizational and institutional claims regarding professionals and their activities. Other studies of professional work as a historical process have emphasized the political and social power of professional groups in medicine and management accounting. More recent historical work on the professions has examined the export of Western professional ideals on economic and legal systems to Latin America, emphasizing the impact of local political struggles on the success or failure of such export attempts.

Three Models for Embedding Professionals

Early sociological efforts to consider professional work and the structures where that work takes place are best exemplified by models developed by W. R. Scott and his colleagues. Scott discussed three models for embedding professionals in organizations. Autonomous organizational forms represent the ideal-typical practice setting, where professionals retain authority to control and evaluate themselves as a group. Heteronomous organizational forms subject professionals to more line-authority control, as exemplified by health care managers in managed care organizations. Conjoint organizational forms produce separate [Page 710]domains of power for professionals and administrators who recognize the shared benefits of their division of labor and collaboration.

The different dimensions of professional work that are subject to change have been discussed by Eliot Freidson and by F. W. Hafferty and D. W. Light. Changes in the actual “content” of professional work refer to specific decisions made and procedures used during task performances. In medicine, the proliferation of practice protocols and research on medical effectiveness represent examples of attempts to limit control over the content of professional work. Changes in the “terms” of work refer to characteristics of the professional work contract (pay, hours worked, and reimbursement arrangements). The replacement of fee-for-service delivery with salaried work conducted according to fixed schedules would be an example of changes in the terms of work. Finally, changes in the “conditions” of work refer to changes in the organizational structures, staffing arrangements, and resources made available for professional practice. The rising expectation that academic scientists will produce patentable discoveries and large research grants to pay for their laboratory infrastructure is an example of this change. Changes can occur in any of these domains independently, but changes in the terms and conditions of work often have implications for the content of work that is performed.

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