Presentation of Hegesco project at the Faculty of Medicine; Presentation of Hegesco project at the Faculty of Social Sciences.

Professionalism and Professionalization

Professor Julia Evetts, an expert in the field of Sociology of Professions from Nottingham University, UK, explains the concepts and notable changes that have occurred in the field in recent years. With her international reputation she has contributed extensively to the conceptual, theoretical and empirical elements of the subject. With her extensive experience of policy, practice, evaluation and assessment in the field of the sociology of professional groups, practitioners and clients, she agreed to answer a few short questions on the subject while on a short visit to Ljubljana.

1. How would you describe the terms profession, professionalization and professionalism?

The terms are very different. The term profession essentially means a generic category of a particular type of occupation, usually one that involves knowledge, a service and an extended period of education, training and work experience with an experienced practitioner that has been practicing for a number of years. Professionalization is, and I must emphasise that these three terms have primarily been differentiated in the Anglo- American tradition, the process of becoming, in which an occupation seeks to promote itself or be promoted by external agents into a professional occupation. Professionalism is rather different in that it has a longer history but essentially it is an occupational value or a normative value, something that in effect is a good thing and is worth preserving and worth protecting, because someone that exhibits professionalism is essentially doing a good job in providing a social service that is valued and useful.

2. Do professionalization and professionalism go hand-in-hand?

Can I answer that both yes and no? Professionalism and professionalization have sometimes been seen in opposition or in contrast to one another. Professionalism is a functional occupational value that provides civility and stability at the macro level to the whole social system. Professionalization is more the process of the occupation trying to protect its practitioners by closing the market to a particular occupation so that only those that are trained in that particular category of knowledge can practice that occupation. So it can be seen as rather self interested in respect to the social practitioners themselves. Clearly they can however go hand in hand in that following professionalization, when an occupation has become a closed occupation, then the practitioners in that occupation can exhibit professionalism.

3. How has the use of the term professionalization changed in theory and practice in the last few decades?

Professionalization has changed less than professionalism itself I think. The process of professionalization has been pursued by numerous occupations recently, particularly by occupations in the health sector who have attempted to regulate the occupation, standardise the education and training to be received and often moved that education and training into the tertiary or university sector in order to add status to that particular occupation. So it can be seen as something that is done in the interest of the professional practitioners themselves, but it can also be functional to the extent which occupations regulate or are regulated. It is a useful thing because customers clients, patients, students and school children can at least anticipate that the service they are receiving will be of a particular standard.

4. Which occupations and sectors are experiencing the biggest changes?

Well of course in the current economic climate you could say banking and finance, but that would be a rather glib answer. I think all occupations and sectors are experiencing big changes because regulation is now a term that is being expanded and extended to all kinds of work. So whereas there used to be a degree of autonomy or discretion in prioritising work and how long you could spend on particular tasks, very often now this is not the case. Work of all kinds, from the most menial to the most high status professional work, are now experiencing changes in that the need to achieve economy in the offering of a service means that regulation often increases paper work and minimises the time that can be spent with customers and clients.

5. To what extent can the terms professionalism and professionalization be related to the field of vocational education and training?

Of course the term professionalism and professionalization can be related to vocational education and training, as you want a good plumber if you are in a crisis situation with a leaking tap or toilet, likewise with an electrician or a carpenter. Gas fitters for example fit appliances that run on gas, these appliances are dangerous and apart from anything else they can leak carbon monoxide which can be lethal. Gas fitters are therefore very highly regulated and the fitters that fit these appliances have to reach a very high level of practical and theoretical knowledge in the fitting of these appliances. So obviously it is a mixture really and I think the tendency is to professionalize manual work as well as service sector work, which I have no qualms with because I believe all occupations can exercise professionalism. So would we eventually see that the occupational group will professionally acquire or move towards a more professionalized occupation? Again it depends on how restrictive your use of the term, the term professionalism is wider and much broader. Professionalization is about movement towards becoming a profession, which is a specific category of knowledge based service sector occupations that are based on abstract knowledge. So all occupations can exercise professionalism, but they cannot all professionalize and they cannot all become professions. Do you think that doing a good job is enough for describing professionalism or is professionalism more of a reflection of what you are and what you are performing? Does it make sense if someone is doing a good job but is not passionate and does not identify him or herself with what he or she is doing, although they may do it? It does not only mean doing a good job. But it does mean being committed to providing a good service whatever the occupation involves, which is why it is a normative or occupational value. It is in a sense somebody that is self-driven and self-motivated. An old term that I could use to describe this is being ?inner directed?. This is somebody that does not really need a supervisor or a manager because they themselves want to do a good job so it is removing the need for constant supervision, checking times etc. Therefore it cannot necessary apply at all levels, which is why it usually begins at the higher status levels, but there is no reason in my mind why people who are vocationally trained cannot exercise professionalism. Besides, you do want a job done by a professional, someone who is committed to providing a service however long it takes. This is one problem I have with time limiting practitioners. If practitioners are told, for example in social work, that they can only spend 10 minutes with the client, and if the social worker in interaction with the client senses that that client actually needs a lot longer to work things through then you expect the social worker to give that time. I don?t think that is any different from a plumber. If the plumber is called because you have a leaking tap and if he or she finds a very inadequate plumbing system in the house, then you really want that plumber to identify the root cause of the problem. So you think the complexity of tasks is not related to this term. You mentioned plumbers, but can you go much lower down the scale to cleaners for example? Cleaners can exercise professionalism; they can do a good job. You mean doing a good job in objective and subjective terms? I think so. If a cleaner is motivated to do a really good job and you then wanted to assess the cleanliness of a ward or an operating theatre or whatever, then you can do that. I do believe the terms are different and I do believe the term professionalism can be applied wider and further than what are usually recognised as the traditional professions. But still there is a difference in the way that you can assess that a plumber has done a good job. What about in the case of medical professions? Well yes and no. Doctors can sometimes make an error of judgement because medicine is not an exact science. But doctors can exercise professionalism. A pragmatic definition is that these are professions that are knowledge based, in the service sector and built on abstract theoretical foundations that the practitioners then apply in complex cases using his or her knowledge and experience to come to a decision about a patient who is presenting symptoms, or a client who goes to a lawyer and wants advice about submitting a claim. I don?t see that as very different in terms of exercising professionalism. Of course, doctors and lawyers are very different professions whereas other occupations are not because in the past they have been less knowledge based, but now some of them, I gave you the gas fitter as an example, are needing to become based on not necessarily theoretical or abstract knowledge but certainly a very wide knowledge of appliances and the likely dangers of them being installed in an improper way.

6. What is the difference in observing professionalization and professionalism at the personal vs. occupational level?

I suppose the best way of seeing that is what in sociology we call the micro and the meso level. Occupations I would call the meso level, the middle level of analysis, whereas micro is on the personal level. With professionalism I think we can appreciate when customers are satisfied. When a doctor, lawyer or a plumber actually has satisfied a client then it is certainly the result of that practitioner exercising professionalism. The only way you can observe professionalization is by looking at an occupation and how its position, its system of education and training and perhaps how its social status have changed over time. Is it relevant to ask if someone can become a better professional? At the individual level of course, if their levels of customer satisfaction increase over time then you can interpret that as becoming a better professional. And so in the same way is it relevant to ask if a certain professional group can change its position over time? Again there is a very interesting way of looking at this and again I shall offer the example of social work. It has been argued by a German colleague, Andreas Langer, that social work has utilised elements of management in its training of social workers in order to increase and improve the status and standing of the profession. Include business training such as MBA type modules in the training of social workers as a way of improving the status of social work and its social standing as an occupation is an interesting strategy at the meso level. So there is no way at all that including different aspects into training cannot improve the way in which the occupation is regarded.

7. What is the difference when comparing Anglo-Saxon countries with continental Europe in the context of professionalism and professionalization?

Well I suppose the story really started with two books by Burrage and Torstendahl published in 1990s, which addressed precisely this question and looked at the differences and similarities between Anglo-Saxon countries and continental Europe. I have argued recently with a colleague, Lennart Svensson, that we are now experiencing convergence in the way that continental European professions can now be analysed using the same concepts as the Anglo-Saxon tradition. The difference really stems from the role of the state. In continental Europe the role of the state has been more prominent and dominant historically, whereas in Anglo-American society the state had not interfered very much with the professions other than to delegate to them regulatory rights. Now I think that it is fair to say that no state in continental Europe or Anglo-American societies is going to delegate these powers to an occupational group. There was one hypothesis that in Anglo-American countries the state is actually an organisation of occupations? We also have the concept of the regulatory state, which is where the state interferes when the professional occupation cannot, or for what ever reasons will not do it itself. So we do find state intervention, but historically the state has left it to law, medicine and pharmacy in particular to sort out their own houses. I want to see these occupations, particularly these high status knowledge service sector occupations, in charge of their own work processes and procedures so that they themselves set the targets and the performance indicators, because regulatory government cannot do this. That for me is a critical factor. I don?t have any inherent objection to targets and performance indicators as long as it is the profession itself that is setting them. The problem with these being set anywhere else, particularly by managers and management, is that they have unintended consequences. When these organisations are given targets they focus on meeting these targets and do not then do the less measurable aspects of the work. Also when hospitals have fixed budgets then sometimes (surgical) departments have to close for one or two months of a year until a new budget comes into force. The profession itself has to be in charge of these targets, but even that does not always work. A prime example is schools and in particular the setting of tests in junior and secondary schools, which means that teachers are now teaching to the test. Is that education? It is so difficult when these targets are set by those who think they know how to measure, when this is a service that involves things that are immeasurable.

8. How can the large scale survey of graduates in the world of work, five years after their graduation contribute to the theory of professions?

I think this large scale survey of graduates and in particular the study of competences could be linked back to the concept of professionalism. I believe that what the survey of competences is looking for is a way of finding out where those people who do a good job acquire relevant knowledge, whether it is tacit and experiential or whether it is academic or theoretical. Obviously it is learnt in a variety of places beginning in primary and secondary schools and then continued in higher and further education, with the general abstract knowledge learned in education and the tacit experiential knowledge from a period of time spent working with an experienced practitioner. Again, I think that if the large scale survey can come up with answers with respect to where and how this is best promoted, then I think that that would be of tremendous value to both education and the world of work. But there needs to be a conceptual link between the notion of competence and the notion of professionalism and that needs to be worked through much more clearly. One easy way of seeing this is to view competences as a more objective way of defining the rather more subjective and vague notion of professionalism, provided these links can be demonstrated.