An Essay on the

Division of Expert Labor

Andrew Abbott

The University of Chicago Press

Chica@ and London

nte Universtty of Chi- Pres, Chica* a0637 The UniversiQ of C h k ~ o Press, Ltd., Lotidon

"i 1988 by T k University 4Chi-ago al ri&ts reserved. Pub'shd 15388 Printed in &-a United States o l A m +

W % % o t 9 ~ 1 ) 5 @ 1 9 0 8 9 8 8 W 1

I i b q nf Congres Gataoptng-in-Publicstion Data

BibIiwa&y: p. f ncludes index. I. Prafessions-United St.ates. S. Pmfessíons-

Crwt BriLain. 3. Pmfessions-Eump. f . Title. HD80".tiSAPjiB 1W 331.7'18'09 87- ISBN S-0006Wf

Preface

1 Introduction The Profes&ns Literature 3 The Concept Cases of ProfesSu7d I e u e b m n t 20

2 Pmfessional Work

3 The Claim of Jurisdictian

Audiences 59 S m k n t s 69 fntarnal Structure 79

4 The System of Professians The Insp~icatbns of Exclwion: A Systm of Professions 86 Sources of System Iisturbanees 91 The Machanisms oflunsdiction Shifi: Abstraetion 98 Conelusion 111

5 Internd Differen~aaon and the Pmblem sf Pwer 117 lnternal Sbraefieation 118 C1'iC.n~ D$firent&tMn 122 Worklace, Work&ce S t w u r e , and I n t e d

Cart?ar Partem 129 Power 134

6The Social Envimanent of Prtlfessional Devebpment 143

Forces Opening and C&ng JunSdMions 144 Tke Z n t e d Organizntton ofProf@s&na¿ Work 150 Changing AudiencesforJuTisd~mI C k 4 m 157 Co-optabte P m r s , Oiigarchy, ami the New C k 167

Changas in the Orgaanization ofIc'mb&e 177 New of legitima@ 184 The Rise of Unioer&ties 195

8 %e Information Professians Thic Qualitaeue Task Area 21 7 Tht: Qwintitatiue Tásk Area 226 Tke CombinedJunsdiclion 239

10 The Canshuction af the Personal ProbIems Jurísdiction M

The Status of Personal P r o b b , f B50- 75 281

On a brave spring morning in 1973, 1 cat with two psychíatrists in the oEce of John R. Collier, superintendent of Illinoisk Manteno State Hospital. After ayear observing rhe use of ps-hiatric knowledge in an ouwtient clinic, 1 was now ready to matyze the s-ger world of the mentaf hospital. Fknds had introdueed me to David Turner and David Klass, consultant specialists at Mmteno, the great chronic hos- pital that anchored the Illinois state mentaf health system. The plwx overwhelnted me. Dozens of ward buildings covered a square mile of praine. So repiar wm their fannation that when we híid passed beside the oorthemmost ward on the way to the administration building, f had seen through its porch w h e s the mncentnc outlines of equivatent mhes on ward after w d to the very end of the hospital. While Collíer r e d my little letter dintent, 1 lmked out at the briskly snapping state Aag and thougbt of Foucault finding in those arches the tnumph of regufarity and onler. Turner and Klass joked quietly. Finaily, Collier gianced up. "1 don't ssee why you need to go on the wards to study psychiatric knuwledge," he grinned. "Al1 the psychiatric knowiedge in thts hospitaf? sítting right here in this room."

I wm later to see what Coltier had meant. To care for its 3,500 pa- tients, Manteno employed only une hd-certif ied psychiahist m d indeed only three or four Licensed physicians. Most medid a r e was perfornied by unlíeensed foreign dactors, who were at that very mo- m n t dmadíng the bmd-new Federal Liensing Emination. Turner L U I ~ Kks , by eontrast, had both been chief residen& at the Universiv of Chicago; in an official se=, they and hne-Marie Rohan, the one boardertified s M memkr, did indeed possess al1 the psychíat~c knodedge in the hospihl.

xii P r d i

"fn an otfieial sense. . ." U"hat is it to p s e s s and control exper- tnel" ARer Five years at Manteno, 1 hiid spent more time with w n t d ptients, seen niore oftheir actrvities, and endured more of their jokes than most psychiatnsts do in a lgeiime. I had bst pool matches :so manic-depressives and poker garnes to schizophrenics. 1 had dodged clutching fingers that hrtd kiUed four less-agi1e people. 1 had conversed vvith an elderly rnan who lived what Wittgenstein m t e . 1 h d helped actminister several tons of thorazine, meIIaril, lutd their musins, and the pouds of wgentin md .Mane to control their side effects. Yet, "in an oBckal sense,"' five yews at Manteno did not make me an expert on the insane.

They did, huwever, make me wonder why 1 was not. 1 went on tu wríte a thesis on psychiatfy as n profmsion md then began to consider the general issue of how d e r n societies inszitutiondize exprtise. 1 knew that the common form ofthat institutionalization was professional- ism. Many writers had studied professionalism, but few, 1 felt, studied the basic wnditions and contexts of the control of work. Most studied the organilalion and dliation d pfactitioners, and, for mast, profes- s~ofialjsm was either a phenomenon h-ppening to idividud profes- sions ora ~yand sea change in the occupatianal system generally. There was in this work t ide sense of thu squabbles between the Manteno psy- chologis& and socíd w r k e n over who cauld interpret d i a e s t i e tese, of the war between our attomeys and our were ineompetent ta stand triai, of the ner, and Rohm on the ane hand aná 0 t h . Of murse, al1 of these prob1ems had been studied idvidualfy. But with tfie exceptionofsome work by Everett HughesS students-par- tieuhly Eiiot Freidsan, Rue Bucher, and Anselm Strauss-there was no theory about them. Them was certainiy no attempt to see these intefa>rufessiond battles as central aspects of pr&ssiondism, rather than as isolated movements and pathologies.

In typieal Ghi-~ fsshion, then, this bouk grav out of my experi- ences as a partieipmt observer. That the h k S evidem is rnostly his-

should not obscum ib fieldwork origíns. My Manteno years, imd the clinic year befbre them, forced me tawanis a theory that could reconcile the hiftoricd continuity of professional apwaranees with the &y-to-day dixont.u>uities of professiond redity. I exwrienced this disjunction quite pemndIy. Mateno psychoko@sts agerly prutiei- pated in their professiorls war with psychhm, aetively lobbfing for t h U r i - w wpent. Yei tbeir everyday professiond world was so in- scteure tbat t h q protested in vain whea administrators p k e d my un- ceI.ti6ed self into the civil seMce "prrychologist" classifimtion.

P r e h Kiü

'Yet these loml vicissituda reBect larger reality, and a sedous themy of professiond developmnt must embi-ce and expbn thii b g e r re- aliw as well, MantenoS pmfessionats strualed within a histofical envi- mnment ofpeculiar intensiq. Deinstitutiondization of mental patients was in fuU swuig, destfoying professionals' jobs as it hilfilled their ide- ol^gies. Biol@d psyehiaq was rapidiy r a u p i n g the doctors' psi- tion a@nst the mumeiing pmfessions, dthough token m w m i e s were m b g a substan~d wuntemttack. Within the counseling are& itseEf, psychmaiysis was at Iast losing its monopoiistk d o m i n m , and the B d tide of n o n d i c a l psychothempy begnning to fíowr. It was a time of great hope and change.

Yet the pr~ai l ing feeling of the hospital wai of decline. Around us s t d mute witnesses to the death of the asylum. When 1 stayed at the hospital on summr eveningf I would walk at sunset past rank on rank of empty wards, past swings and e m w s unused for thousand-me hospitid fafms had been nrnted to sod and wrn f m r s . The great southern lawn had become a public goif murse, The diese1 s+tching enEjne s t d idie by the pawer plant, behind the empty ktchens that had once fed ten thousand persons a &y. pwer phnt, the r a i l r d siding snaked hrio weedy mifes lllinois Central &acIca, passing an orchard where a few hardy trees sti'U produced wurm-eaten h i t . On sueh an evening, the whole histury of the asylum hospital glearned on the signs m i n g the wa&-the idedistk founders Pinel and Dix, the famous Europeans Kraepelin, Fmud, and Adler, the gceat Amerias Rush, Meyer, and Mitchefl. There were huildtngs, tw, fOr other pmfessions important to the ay+- lum hofpitaf--Barton and Nightingilie for the nurses, Addams and Wmes for the social workers, fames for the psychologists. ff 1 have eaptured in this book a sense of professions' transiency, it mes much to this experienee of the dying hospitd.

This b k , then, aims to show the professions &rwUWIng, spiitting, joining, adapting, dying. The objeets of its analysis inciude a wide va- riety of professions in the Unitd States, E n h d , and, to some extent, F m a and the other nations &continental Europe. 1 have been e a t h lic in rny ttastes, Qing tu o&t the customar~ reliarice on Amedean iaw and medicine. (1 have generally avoided writing &out aeademic pdss ions , hoping to escape eharges of navel gazing from nonaca- a

demic readers and the cense of we-knm-it-dl-already amang academ- ia.) The brryadth of e m p t e s requíres the usual difctairner a synthetic miter makes to area specialists. Few of these analyses other than those in my own primary research areas wiU set?rn sophkticated to spcialists an individual professions. I have done rny best in unfamiliar teni te

ries, but doubtfess many minor errors remain. On the other halid, that I wríte such a bsok testifies to my beiief t h symthesis will prove more worthwhile rhan further area w r k . Retlders can judge for themselves whether that befief is mrrect.

Sinnr the rmts of the book lie in my persoml experiertces and ob- servations, my fimt debts are to those who got me into the field; to Morfis Jmowitz, who pushed me into fietd study in my first year at Chiago; to Jarf Dyrud and Dave Klass, who got me into Manteno; to Uíiss an8 Jon Steinmtz, who managed to suppurt me there for five years. Llke al1 &Id observers, 1 have great d e b s to my subjects. Un- fike most obsemers, however, 1 have the pleasure, d o r d e d by ten years' time d a book using Iittle of their rvidence directiy, of thank- ittg the most in~portant of them by name. Eberhad Uhlenhuth and his clinic st& ~ i c u l a r l y Rose West, Mark Mouithrop, Dave Turner, Poily Everett, Zanvel Klein, and Jeff Teich, helped me immensely. The Chicago psych-tahic residents of the 1972-1934 clases put up with numemus bumbfings, for the most part with unfililing good humor.

At Manteno rny debes are more extensive, because my stay was longer and my wrticipation more mrnpiete. For officiai authonzations ímd suppurt 1 must pafticularly thank Jack ColIier and his suceessor Ella Curry. For varying degrees of forbearance and helpiiilness 1 must thank the professiond staffs, particularly Solomon Noguera and Luis Wacios among the doctors, Henry Lin among psychoiogists, Nora Brashear and Bonnie Hellyer among social workers. h o n g ward p p i e I wje great debts especially tu Janet Tetrault, Penny Kneissler, Dorig Baldndge, Raymond Marshaif, Dennis Wopkins, Marge Curry, and I-iarold Spearin. Aniong the nonprofessional S@, Amada Rnder, Doris White, and Charlotte Margan were helpful and suppclrtive, as were John Cmyton and Mike Strizich among the Chicago-based can- sultants. Finally, 1 must thank friends whose personal support got me through Mantenok deadlier moments-Dave Kudoif, Margaret Kas- per, Jon Steinmeh, and, dutcissim, Cindi Clyden.

C3ver the years, a n u m b r of frien& in diverse professions have &ked intimately about their work. For this 1 must thank in particular Scott Thatcher. RiehLud Kdb. and fames Gill. iawver. architect. and priest. I have learned much about engineering from talks with rny fa- ther. My mother taught ne about librananship by making me work in v d o u s Iibraries she ran, and 1 have induiged my endunng interest in librafies with indexing theorist Jim hnderson. My Grsthand knowiedge of the m i i i w 1 tlwe ta Richard Nixon.

Beyond these general debts, 1 have some more specific debts for idea in tht? book. The notion that diagnosis and t reatmnt are general

modes of knawledg carne from D o d d b v i n e , and the vwancy meta- phor that underlies chilpter 4 from Narrison White. In most of the b k 1 have softened the vacancy metaphor into a more ecolo@& one so that the relative pos~tions of pmfessions might seem somwhat Iess exciusive, ~ l t h o u g h e m l o g is a fashionabte metitphor in foeiology ta- &y, the b k J m?olo@cai flavor comes directly from Park, Burgess, p&rb.augh, and others of the old Chi-o Schmi. Reading this work in the early IrY?Os, 1 a m e to see social structures as fluctuating and gm- grrtphic, cartceptions that strongly nnderiie this book. They underlíe as well the Chieago writers on ocxupations and professians, and the b k thus lies very much in the Everett Hughes tradition. The h k ' s com- parative emphasis has diverse sources. Although 1 origíndly designed my dissertation study of American psychiatrists without much com- parative knowledge, Joseph Ben-David shamed me into studying other professions and other ~wuntries. The comparative emphasis was rein- forced when 1 was abie to attend two years of sessions on the history of professions at Princetonk Davis Center. Although the Princeton his- torian~ had little respect for suciologists, they did examine an immense amount of information about various professions, and 1 would not have dared so h r d a book without the exwsure 1 iicauired there.

Like any synthetic scholar, 1 owe much to past sociotogiml and his- roncal work. On the sociological side, Joseph Ben-David, Magali Lar- son, EIiot Freidson, and Terence Johnson have been particularly im- p u b t theoretical sources, as have the earlier synthetic b k s of Geoffrey Miibrson, W. J. Reader, and A. M. Carr-Saunders and P. A. Wiison. A nurnhr of sociological calleagues have talked pmfessions with me for years, and 1 must thank them, particularly Terence Halli- day and Michael Powell, for their insights and criticism. To the hista- rians 1 owe a still greater debt, for theirs is the data that undergirds the h k . Although suurces are of course isted where relevant, i must thank here those historians who have personally shaped my ideas: Ger- dd Geison, Steve Botein, Nancy Tomes, Janet Tighe. C e r a Grob, Paul Miranti, and Robert Kohler.

A number of people have read the book manuscrípt, or pieces of it. Terry Halliday, Mark Cranovetter, Doug Nelson, Eliot Freidson, Har- rison White, and Susan Gd gave me very helphl, although often con- tradictor~, comments. Two research assistants, Bnice Cafnithers and Margaret Antinori, helped with material appearing in chapters 1 and 8. Ed L a u m n was helpful at publiation time. Financiai support cam ia s d l amoun& from faculty grants at Rutgers, and in large ones frorn rny d e ' s real world falary from Bell Laboralories. Portions of the mmuscnpt have appeared before, and 1 must thank the relevant jour-

xvi Preface

n its en- w ~ o n s

Adg&. I must dso thank the Hatvad oeioíogy, whose invitation in 1982 pro-

v o W rny first &m& díscussion of the centraf azgument of the b k . A fin; book is the pmper w i a n for wknwledgng he$ of years

íig- th& led, úI its &rcuitous way, to this present. I thank, then, my pments, James w d Rita Abbott, for fostenng me in the tife of the mind iKKi some tetlchers wlxl hrthertrl that endmvor: Seaver Gilcreast, Sr,, Rabert Shiel-ds, George Best, S i m n Hyde, Dudley Fitts, R. H. C d y w , J. P' Russo. 1 thank also t b s e who exempliled b r me what rhat Me wuid be: AIston Ghase, Roger Revefle, Moms Jmawitz.

Lastly, 1 thank thuse who made Iife fun whife 1 wrote this book. hmung niy present m d fazmer coileagries at Rutgers, Stan DeVíney, Andy Szasz, W y Smith, Rob Parker, and Judy Gerson have criti- c i d , cheered, and supprted, as did that anthropol~st who is still my cfosest friend thirty yeara af'ier we were thinf grade sweethearts.

Finally, by her supprtft threat, cajolery, and exhortation, Sue Schktugh probabiy has as mueh to do with the appeamnee of this mmuxnpt as 1 do. She tlid not red it, or tM>e ft, or prepare the index. But she interrupted her plane tnps and expenmnts to do mueh more than her share of the dishwlishina. and cleaninrr (1 think I've held UD - - . rny end of the ironing and coakind. As any two-career eoupie knms, that's a big ded. We've had a q t time while this book was being minen, and that's an evee bigger deal. Thanks.

A.M.D.C. Phillipsburg, New Jersey 14 July 1987

Note for the reader: This is a long book, with long and often involved arguments. To make the argument foltow&Ie, 1 have suppressed al1 eitation in text. This makes the schoiarly mrtchinery harder to bt- fow-something I resent when 1 read-but it makes the b k much more readable. 1 apologize to those who want tu check everything as they go dang, Jams Anderson kindly assisted me with the index. Its unfo~unate brevity was dictated by considerations of space.

The pmfessions dominate our world. They heal our bodies, measure our profits, save our souls. Yet we are deeply ambivalent about them. For some, the rife of professions is a story of knawledge in tnumphant practice. It is the story d Pasteur and Osler and Sehweiker, a thread that ties the lawyer in a country village to the justicg on the Supreme Court bench. For others it is a sadder chroniele of monopoly and mal- feasance, of unequaf justice administered hy sewants of p e r , of RockefeiIer medicine men."neath the impmsioned mntradictions af these interpretations lie some common ssumptions. Most authors study pmfessíons one at a time. Most assume that professions grow through a series of stages called professionalimtion. Most talk hss about w b t professions do han about how they are organized to do it.

These assumptions seem to emerge from our centfal questions about pmfessions. Why should there be occupational groups control- ling the acquisition and application of various kinds of knrnvledge? Where and why did groups like medicine and iaw achieve their power? WilI pmfessionalism spread throughout the occupational world? To an- swer such puzding questions, it seemed neeessary to adopt simpl+ng assumptions. The complexities of the individual pmfessions forced case by case study. The faet that professions tike medicine and archi- t d r e seemd rnare similw in organivliional pattem than in actual work made organizatianal pattem the focus of analysis. The foeus on patkern implied in turn a search for its origins and fed to the idea of a common process of developmnt, the idea of professionalidon. But professlonaih~on was at best a misleading concept, for it invoived more the forrns thasi the conten& of p&ss&naltlfe. It ignored who was dokg what to whom and how, comntrating instead on

1

ation, líeensure, ethics code. In fact, not only did it miss the contents of pntfessional activity, but &so the larger situation in which that w- tivity occurs.

8 y fmusing on patallels in organizatíond development, students of the prafessions lost si&t o$' a h n d m n t a l fwt of professiond Iife- interpmfessional cvmpetition. Contml of knowledge and its applica- tion m a n s riuminating outsiden who anack that control. Control with- out ~wmpt i t ion is trivial. Study of o r w i a t i o n d forms can i a d d show h w ceftain wupat ions control their knowiedge and its applica- tion. But it cannot te11 why those forms emerge when they do or why they sometimes sueceed md someti- fail. Only the s h d y of com- *titiun can acwrnplish that.

The pmfessioi~s, that is, make up an intenlependent system. In this systein, each pmfessian has its =tivities under various kinds of juris- diction. Sometimes it has full control, sometimes control subordinate to ariother group. Junsdietionill boundaries are perptually in dispute, both in t d praetiee and in national claims. ft is the history of juris- dictiorial d i s ~ u t e s that is the real, the determining historv of the professions. jurisdictiond claims furnish the impetus and the pattern

. n i u s an effeetive historical sociology uf pmfessions must b g i n with case studies of jurisdietions and juris- dietian disputes. It must then píate these disputes in a larger context, mnsidering the system of professioas as a whole. It must study such evolving systems in several muntries to assess exogenous factors s h a p ing systems of pmfessions. Only from such partraits can one derive an effective m&( fnr understanding and predicting professional devel- opment in modern societies generaLiyYS

The movernent from an individualistic to a systernatic view of pmfessions organiuls this b k . 1 begin by evdiiating the idea ofpro- fessiondi-ation and move an ta theorize the systematie relations of professions. I then andym externa1 f o m s bearing on the system and close by discussing three imporbnt evamples of contested jurisdie- tioas. Thmuyhout, I addresss the familiar questions &ut professions. How do pmfessions develop? How do they relate to one another? tVhat determines the kind of work they do?

But this summary slights a methodoloe;ical theme that accompanies the s u b s ~ t i v e one as harmony does a melody. My substantive ques- tions dl invoive generdizing about stories, such as stories of profes- siondization. hly methsdoIogical m n m m is with how this generaliza- tion takes place. T d i t i o n d theories of professiondization argue that proft3ssíons MIw a e e W sequen= of devebprnent. This "careers" mde1 is une w q t.u generalhe about sequencTs of social events. My

fntraduction 3

t h m t i d scheme, particularly in Chapter 4. illustrates a digerent wsy of generaflzing about sequenws, one that makes them interde- pendent. Sime jurisdiction is the defining retation in professiond life, the s q e n c e s that 1 generdize are sequences of jurisdictiod control, describing who hod control of what, when, and how. Professions de- veiop wben jurisdictions b m e vacant, whieh may happen because ehey s e newly created or because an earlier t e m t has left them aito- gether or Iost its firm grip on them. If an utready existing profession t&es over a vacant jurisdietion, it may in tum vac.ate ~ o t h e r of its junsdíctions or retain mereiy superviso^ control of it. n i u s events p m m t e b a 6 k w d in sume sense, with jurisdictionat v m c i e s , mther than the professions themselves, having much of the intiative. This simple system rnodel shows how a set of hístoncal stories rtan be andyzed without assuming a common c a e r pattern, as in the cancept of professiondimtion."

Throughout the book, then, run two leveis of andysis, Suhstan- tively, the bmk answers sume questions about the evoiution af profes- sions. Methodologicallyy it considers the dimculties of generai ing a b u t sequenees of evvents ;md proposes a new way to address them. It k h does historical sociology and asb how historieal smblo@ ought to h done.

The Professioos Literature

Aithough the professions derive from medieval or in some cases an- eient origins, the first systematic attempts to study them m e in this mntury. In part this refleeted the rise of the social scienees, but it refiected more importantly a great change in the professions them- selves, The nineteenth c n t u r y saw the Grst development of profes- sions as we know them today. fn Englmd the merging of apothetanes with surgeons and physicims, the rise of the lower hranch of the legal profession, and the appearmce of the surveyors, architects, and ac- countants signded the change. In America the triumphs of regular medicine over its various sects, the growth of the univenity profes- siona1 schools, and the host of would-be professions al1 testified to the ntiw fonn of occupafion. "

The nineteenth een- professions were important but peculiar M-

cid creatttres. With the exmption of a m u n t h g , they stood outside the new commercial and industrial heart of society. They were orga- ni& a collegial mmner that was distinctly anrrchntnistic. On the Continent, to be sure, the pmfessions were more hierab-chid. But this h i e m h y carne not from the new capítalist forms of orwiilttion, but

rather fmm the Old Regimct, h m whieh it acquired a civil servant quite p u l i a r ia the rnodern ~ n p a t t u n a l world. The profes-

sions, ami in partieulsr the Ando-American variety, were therefore a great p u d e for social theorists. Weber spent many embarwsed pages confmnting the wanton irrationaiity of the English Bar. DurMieim srmply iwored the Angla-America prohssioas altogether and iooked to more f m i l i a Freneh occupations for his neacowratist future.$

It uras the Endish themselves who perfora first andyzed these un- usuaf occue ions . Cárr-Caunders and Wilsoni The Professutns, puh- lished in 1934, w s the first sueh attempt.@ The hook gave historicat background on every group that coitld then be considered a profession in E n g l d . Its theoretical diseussion systematized a view of profes- sions that had by then come to dominate the writings both of the pmfessions themseives and of the social xientists examining them. Prufessions were orgmized M i e s uf experts who applied esoteric knowledge to partieuiar cases. They had elaborate systems of instrue- tian and tmining, together with entry by examination and other formal prerequisites. They normdly possessed and e n f o d a d e of ethics ur behavior. This list ofproperties becarne the core of later definitions.

The Carr-Saunders and Wilson volume epitomized two methodolo- @es c h s ~ c t e n s t i c of writing on pmfessions, combining naturalism and ~.poiogy. Eatly árticles on the professions would summarize the life history of their particular case, review the then-current essential traits of a b e profession, and decide whether socid work or nursing or whatever reaily was a profession. 'Nork in this genre mpidly built the stock of case studies, fitting each case into the pmmstean hed of es- sentid traits. But that bed was so often refinished as it passed from hand to hand that the case studies were never very comparable. By 1964, when Geoffrey Millerson attempted a new general analysis of professions, he had to treat earlier work as merely advisory and build on new data in a new framework.? Millerson recognized that trait-based definitions had often reflected political concerns. If one disiiked social work, one easily found some trait exeluding social wark &m the pres- ti@ous category of '"professions." H e himself avoided this by identtfy- ing only v e r - general tratts of professionalism (e.g., organizltion, edu- cation, ethics) and then permitting wide variation within them.

Other authors c o n h n t d this empirical diversity more directiy. An early and p i m v n i o u s answer came from the t h ~ r i s t s of profession- alization. The diversity of the would-be professions arose because pro- fessional status wapr an end state that few had yet achieved. Diversity ~ u l d disappear wíth time,, as mup p d u a l l y q u i r e d al1 the narks of true professions. The mncept of professiana1~ion thus mnsum-

mated the ~narriage of naiuralism and typoiogy. Prnfessíodization was a nabraf pmcess, as in the case study literature, but that process e n t d e d a series of types. In 1% Harold Witensky published an íirticle that demonstrated such a regular sequence in the h r i c a n professions. Professiondistion seemed an eszablished fart. The newr mncepbdizLltion meant in turn a new thmretical question. Why did pmfesionalization follw the sequence it did?

But just as professionafization beeame an established mwept , the study of professions was suddenly reshaped by the new political cii- mate of the 1960s. Early work on professionalization had rested on the func t iod assumptions cbaracteristic of postwar sociology. It attrib- utml the colle& o r w h t i o n of professions to their position as ex- perts. The "asymmetry of expertise" reqnired the elient to tnist the profefsiond and the professiond to respect both clíent and colleagues. These reiations were gumnteed by various institutional forms- associations, licensure, ethics d e s . But theorists rejecting Eunctiod assumptions disputed the whole picture. In a lucid analysis of profes- siondism as a form of cuntrol, Johnson argued that the pmfessions did not serve disembodied swial needs but rather irnposed both defini- tions of needs and manner of service on a t o m i d consumers. Writing on Americ;rui medicine, Elíot Freidsan argued that dominante and au- tonomy, not collegiality and trust, were the hallmarks of tnie profes- siondism. Another student of medicine, J e e e y B e r h t , attributed the structures of professiondism directly to the goals of w n o m i c mo- n d y . BerIantS work was the more stnking in that the feature ofpro- fessionalism whose monopolistic funcáion he most cxefully andyzed vas ethics d e s , whose dtruistic nature had been assumed by eariier workers.&

By seeing monopoly rather than control of asymmetrie relation- ships, the new theorists moved the focus of debate from the fonns of pmfessiondímtion to its functions. For the new theorists, the regu- Iarity of professionafization was not the visible reguiarity of schmt, then assmiation, then ethics d e , but rather the hidden one of s u c eessive functions for these professional forms. Ethics d e s came late in professionalization not because they were a culmination of natural w & h , but because they served the function of excluding outsiders, a function that important oniy after the professiond community had 'been generated and consolidated. Since ethics d e s did not serve these eartier functions, they m e late.

The new v e r literature thus unmasked earlier work as ideolo@- cal, This unmasking reached its final f a m in Magdi Larson? The Risa of Prof.~sionBIism (l.%"?). Were professions were explicitiy market or-

6 fntraductian

~ i & i o n s attenpting the intellechal and organizationd dominatian of areas of soeial eancern. 't'et even while it reversed the traditional irníges of profession anct professiond, h o G s bovk d r w on themes ltnd msumptions s h d d thmughout the AngleArnen~ati study of pmiessions. The old model wris aceepted for new rensons. Sinee she east professions as m&t dominating organizations, the prufessíons of the Continent, where etxpertise wss never formal- ized independent of the state. Like her predt?cessars in the power trditíon, she explicidy excluded thu orwizlttioa-brised professions- rumtd m d civil sefvice and clergt-that continne in the Ando-Ameri- can world the i.tistitutional forms of the Coixtinent. Through her focus on dornsnance she ignured professiow like nursing that had aaep ted subrdínatíon. The exclusions shouId w m e as no surprise. By aceept- ing pmfessiondiwttion as the thing to be mplained, the new power theuristi aecttpted the assumptions behind the eancept. These in- cluded not only the idea of a íixed sequen* of events or functions, but dso wsumptkns abaut the h s t examples of professionalism (American medicine and Iaw), a h u t its essential qualities, and about the c h m t e r of the intefprofessiud world.

The split h t w e e n the Cnctiondists and the monopolists was thus not totai. It was abo not one-dimnsional. First, the two groups em- phasized dítferuat eonsequennces of professionalism, BerIant and Lar- son were intemsted in the eonsequems of m e d i d professiondism not for hedth, but rather for the status and power of the medical pro- fession. '%ase were external, social consequences that derived h m professional stahts or activity; siekness ww of littie interest. Other w i t e n emphasized internal consequences of professiondism, ronse- cluences affeding the afea uf professional wark itsetf-healing, audít- ing, and so on. To k o n s , for example, the impact of professionalism on sick individuals was a f central i m p r t w e . Yet it was also central for Freidson, whose critica1 stance otherwise identifies him wíth h o n and Berlant. This contrast between Parsons and Freidson indicates the other dimnsion of the split, which concems the locus of anaiysis; like h a n but unlike hrsons, Freidson aimed his wdysis at the social level. H e wked haw the overdl social handling of iliness was affected by the existen* and nature of professiond groups. SimiIar1y, h o n S eunctsrn wirh the external consequences of professiodism extended to the pmfession as a whole. She asked what professions got out of professionAsm and how. Parsons and other functionaiists, while con- cerned, like Freidson, with intenal mnseqnenms, saw them at the individual level. Huw, they asked, does a social relatíon b e h ~ e e n client and pro£essiori;xl have to be stmtured for healíng !$r some other id- vidud professianal aet) to oceur?

Of murse, the cmssing of rhese km dichotomies implies a burth a p p m h , oae exarnining externd fonseguences, as do aod Brlant, but at the Ievel of individuals. This view has been argued at k n g b by Joseph Ben-David md Burton Bledstein, Both emphasize the f u m a n of prafessionatism in proteeting certain índividuds-the pmfessionds themmlves-from the struetured, rigid employment that emerged with nineteerith century ccrpitalism. Beyond this independ- en=, tbey both w e d , pmfessiondism alfa providd both an ideal mrqhor for vertical mobiiity and the means with which to aMempt it. This arpment defines the chief impliations of professiondism as its externaf consequences (status, money, power), but at the individud fevel. Probssisnafism was a matter of indívidud choiws and rowpate action &en to pmtect or extend them.s

The librature on professions has thus grUdualfy moved from natu- ralism to theory. It bgan with case studies and typoiopies. The inter- nd mntradictions of these studies led ultimately to the idea of profes- s iodht ion, in wkch a dwelopmental typoloti;y generated the natural histories, pdueing an apparent variety of professions. For the p w cess of professiondiz-tíon there then emrged a variety of theoretieal interpretations. For some, pmfessiondkm was a means to tontrol a difficult social relation; fnr others, a species of corpomte extortion, For stiil others its impartance lay in building individuai whievement chan- nek, while a fourth graup emphasized how it helped or hindered gen- eral social Eunctions like health and justice.

Despite their substantive differences, authors of these thearies took a surpnsingly consistent view of what professions were and what about them must be expsined. Certainly all agreed that a profession was an ocvup&ional group with some speeid skill. Usually this was an abstraet skiil, one that required extensive training. It was not applied in a purely routine fashion, but required revised appliation case by case. In addition, pmfessions were more or less exclusive.

This mnsensus seems surprising in light of the squabhles charaeter- istic of the períod of naturalistic studies. For many years the defini- tional question was the f d issue of studies af pdssions, ohxuñng the substantive questions that made professions uiteresting in the first place.'0 But of murse the suwrising mnsensus of theoretical writers refleeted the pface of definition in theoretieal work, where it is a means to substantive en&. The mnfusion over definitions arose mainfy in witing that liicktxl heoretical íntent. There, definitions were judged by their ability to regenerate common opinions. Since those opinions were o - M around the fmiliar emp1es of Amencan law and niedicíne, definitions excluded things that diddt look Iike law and ntedícine, sueh as automobile repair, and included thrngs that did, like

atxwutltirt:, aild perkops s<xt.ial work. There were arid are fuiidanrerital cfiCFicirlties witf-i this test-by-exanipfe. First, A~neritan law and rnedi- cine do nut in fact Iutk like onr images clf them. Only hatf of each is c~ilirtnt;>loyed. TIre vzt tnajorie of w r k in b t h is utterly rootirre, A s~iqrisirig rirrirri-wr itf prctfessionals, everi in these fields, will be in ünothrr <x:cripationai clüssi[icatiun in twenty years." Securid, maity I I ; ~ U I I ~ S tfiat ~bvi t t t i s l~ ure prctfessions di1 tiot tcxtk like Ptrnerican medi- cine and law at all. Eirglish barristers cio tlot neessarily traiii in urii- vt'rsit? hilt rather By apprentic*ship and eatirig clinners "in hall." Atnericrarr clrrgy do not generally have ethics d e s nor, uiliif reeently, asstxiiitjctns indepeltdent of their ec~lesiatical structure. Yet k>th KrOttpS are rrnn!istakal>ly prokssions. The urxcierlyiog proitiem is that for rrtany writers, taliing soritethirrg a profession nrakes ít one. People cictn't w ~ i t to cal1 atitontobile repair a profeasion hemuse they tforit want tct accorcl it that cfignity. 'This itnwtlIir~gness pr<>hably tia less to c ío with the acttial char;*cteristics of autrtincrbile repair as arr iritellectiial cliscipline-whieh are cu~r~ccptualiy quite cirtse to those of irtedicine- than it does with the status of the w>rk aild of those who do ii. When dtr&rrititjrks aint t c ~ distingiiish goups accwrding tu sxteh an externai ;ili;enífa. they are disltutct<f. When usrd to ariswer theoretieal ques- ti<urs, thcy are rntt.

Ilefinitiuns, ihen, must I;>llow h m thmretical questions. The theory 1 sketehed in the oi~eiting paragr~phs implies the very hose c1efrrtitic)n that irr<tfcssíons are exclusive t>cct~patinnal groups applying s<>rnewhat abstract knowledge to particular cases. It is imptrriant to show why this clefinitictn is choseri Itere. 111 doiitg so, 1 can fiirther ctritlirte nty fundarnerttal thwtry.

?ity urlderfying <t~~esti<~ris conci<irn thc evolution and interrehtioris of professioi~s, ancl, more geiierdly, the ways ctt'cupational gro~ips con- trol krttlwledge aitd skil1. I have already argued that the evolution of prtttessitrrts in fact results frorn their interrelatiorts. These interrela- tions are in trirrt iieterminud by the way these grorips control their kiio\vtedge and skill. There are h~.t) wther diEerent ways of accorn- ptishitig this cuntrc>l. Oiie ernphasizes teclirtiqrte per se, aild ortcupa- tions tisirrg it ü1-e curnnionly called erafts. To control such an occupa- tiori, a pclrlp directly cw~itrols its tech~tiíiiie. The other forrn of control irtvolves abitract knowledge. Here, praetical skill grows out of ata ab- stratit system tif krto\vledge. and cu>titral of the tmupation lies in con- trol of the übstractions thar gerrerate ihe practieat tcchniques. The techilirlues themsetves rnay in Fact be tlrlegated to other workers. For tne this chwxteristic ctf abstriiction is the une that best ideritifies the prukssiuns. For ai)~trücti~r~ is the quality that sets interprofessional

eompr?titiott apart frorn cunipetition amotkg c~~upatirbns in generaf. h a y wtclcuptiori can vbta~n lieerisui- je.g., beautieiatzsi or develop an rthics d e (e.g., real ectate). But ctilly a kn<xwIedge system gwerned by abstriictitms can redetiae its ~sn>hleins arid tasks, defend thern from interioper-ri, and seize new prcrhlcms-.S metiícine ha'i re~ent ly seized alcohoIisrn, mental illriess, hyperaetivity irt ehildreri, t>twsity, and nu- rnemus other things. Abstraetíun enal,les strrvival in the coonipetitive systeirt t t l prttfessions. I f auto mechiir~ics had that kiiid of ahstrdction, if they " ~ ~ n t a i n e d the relrvant sections ofvr;hat is prtasentfy the erigi- neeriitg prufession, atld had ~u,~isi<lered taking ouer al! repair of inter- rial cx>rnhustion ertgiiies oit abstrüct grtltrr~ds, tttey wtriid, for my pur- poses, krt a prufession. My eentrai cluestions and nty fratnework tiros tletermine m); tlefini-

tlon of prof'ession. As wc have just seen, they determine first its ein- phasis on the knowlrdge system m d its degree «f ahstraction, si~we these are the ultimate ciirreticy of eompetiti<>rt betweeri prtrfessions. But they also dt-termitie its relativity, siiice the degree ttf atlstractian rireessary tOr surviva! varies with tíme and place in the system o f professioits. As sc~iaI work and iiursing have Iretxinir wttefjate profes- sions, ~nedicirle has ixu'rtme postgrduate. tlow aixstract is abstract cnough to be professiunal? The answer depends 01% time and placv. tVhat mUtters is abstraetioir effeetive enortgh to ctclnrpete in a particular hist<ori.il alid social mtntext, t iut alístraction relative to mine supposed ahsoiute staitdarrl. 1 anl interested iiot mes-eiy in the Iíving, doiriii~ant professions like medicine arid law, lrut ajso in the the morihund ppn13s like ntediuins, railway surgeoris, m d electrt>therapists. A definitioti ttw speeific would exelude tiiem frorn view. Yet they too have r n d e their mark on the systetn of professiítns wr st-e tcttlay.i2

The C o ~ w e p t of Professionaiíwtion

Having settled the definítianal isstre, üt least tefl-tporarily, we may rnove on to examine past theuries of professional tlevelopment more closeky. Proi>ably the most rQmmon thenxe of past wurk is that profes- siorts tend to develop i n a corninon patterri, cailed pn)fessiotialization. Is there, in f x t , a i-ommori story of hotv professions develrjp? To an- swer this cliiestion, we must first answer the prelitninary t lr~t: of what w nieün by "cc~mnion story." This (~uestion is tltrite eontplcx. There "nve been matly theories of professionalization, arid they diEer along hro distinetly diffi?rent di~nensions-the Formal a id the sirbstaritive.

t e t us consider formal digerrrnces anrung theuries of professional- iatiorr by stuciyirig some versirtns of the professioridiwtian story. In

the 1% article rnen~oned esrlier, Nmld Witensb discussed what he called "the professionalizatton of eve-ne." Wi1ens.l looked at the dates of "first events" in varioos Ameriean pmkssions-first h-ining schrwl, first u n i v c r s i ~ sch-1, first I d association, first national as- cocation, Erst state licensing law, and first d e of ethics. He found by inspmtion that the events tisud& fe11 in the order just listed. Reflect- ing on that arder, he then made up a story to w u n t For it. 1 shalf p q h m it as fotiuws:

Pmfessions kgin when people "staft doitig full time the thing that needs do- tng." But then the issue uf training arises, pushed by recntits or ciients. SchmIs are created. T b new schwks, if not lteffun wikhín univenities, im- nlediately seek &htion vrith them. Inevitably. there then develop higher

S, longer hsinin~~, earlier wmmimnt ta the pmfession, ami a gruup of fui1 time teaehers. %en the teaching prefessionds, aiong with their first d u a t e s , c-mbine to pmmote and create a professional association. The more detíve prufessional tife enabfed by this mxtciation leadil to wif-regection, to posiibb change of n w , and to an explicit attempt to separate eompetent from incumpetent. Re%e<:tion ahut central t%sks le& the pmfession to delewte rvutine w r k to p;uapn>fesuiod. At tbe same time the attempt to sep&te comptent fmin immpetent le& to internaí mnffict between the u&iaIt.y trained younger generation and their on-tb-jobtrained elders, 8s weU as to incremingty vioient mnhta t ions with autsiders, This periad aiso contains efforts to seeure state p-wtion, dthou& thif does not always accur arid is no& peculiar to profesions in any ease. Finatly, the niles that these events &ve generated. mies eliminating interna1 comptition a& chariatanry and esbblishing client protmtion, d e s c e in a f o d ethics code.lS

WilenskyS story eítnsish of a series of narrative steps, each of which rnoves fmm sihtation tu event to situation. What propels these steps? Here Wilensky is less clear. H e tells who pushes for sehoois, but not why. Presumably he uses some eammonsense theory like "people who are doíng something fui1 time want to do it well," or "see a need to do it well." or "beain to know what ít is to do it well." Note that the c a u d w

rnodels underlying the various tinks in this stary draw on different general views of why things happen in social Iife. Schools arise fUnc- tionally; they 611 a need. Deleption of tasks, by contrast, arises in a histaricist rnanner (success confers the p w e r to defegate, whieh fur- ther snhmees s u e s s ) , while ethics c d e s simp1y desee úlevitabfy.

Who is the subject of thís story? This, tm, is pmblematic. Ethics d e s happen to the profession as a whole. Yet at the beginning of Wibuskyk story, the profession as a whole did not really exist. The initial subjects me "those who do fiill time the thing that needs doing." Through the stew the proiession gatfudly emerges as the new central

subject. of the narative, dthough'often the getlts or chmge :e= h m sab~oups . At one leve[ this seems obvioas enough. One central p m s s of professionaiízation is cdexenee into a group. But there is an essentid dífference between demonstmting emergente as a procriss in the social world and pmsupposing it by t ~ m t í v e s t m d r e . It is the latter that Wileush. has done; ttt least some of the "'fult-time doers" hrwe in Fact become degned ras charlatans by the iatter stages of the story.

rtlthough Wiiensky theorized a generrrl process of professiondiiza- tion, he saw vdety in the actual sequences aid advamd speeial ex- gianations of deviations fiom his overalf story. Theadom Cq~low, in contrast, caw a more stricdy universd story. W ean p p h r a s e it as fitllows:

Pmfessiotls begm with the establishment of pntfwsiowal awiations that have expkit membership rules to exciude the unqualified. Seeond, they c h g e their mmes, in order to ktse tbeir p t , to mert their munopoly, 4, mast importantly, to @ve &emeIves a Iilbel capabie of legishtive reswun. Third, they set up a mde ofettrics to assert their social utility, to further reguIate the incompetent, and to reduce internai eompetitíon. Fourth, they atate políti-

ition, aúning at itmt to lfrnit the mhsionai titie and later to crirninak unltcensed work in their jurisdietion. (The growth of whooling Capíow sees as íwncwmt with this poiiticai rictivity, as he does the establishment of n>nfi&ntiality rights and eEedve reiations with ~uhiders.)~~

Caplaw's story differs hom Wilensky's not only in chronology bnt in narrative strumre as weE. For one thing, it has a ungom central subject. The profession appears at the be@nning of the stary and un- derakes al1 the aetivity in it. For anather, ali links of the story are functional, In f&, there is a seyuence of funetions. Exclusion is in- cfuded in ail four links, a s a i o n of junsdiction in the lwt threcr-, inter- nal control in the last two, md externa1 relations only in the last, This sequence of functions is tnggered by the need for professiomliation, which Caplow derives from Iarger social foms in a sepanate wgument. Yet despite these dBerences, Capiow's story shares with Wilensky's the assertion that there are clear sequenees of proftrssiondim~on,

This clear suassion disappears in professionalimtion as dexribed in Engtish muras. Ceoffrey MiliersonS explieit denial shows the very daerent approaeh he takes to n m r a ~ g professional~tion.

ClearIy aII Quatifying @sin professiad a variety of mwns for establishutg an association; to co-ordinate the adivíties af workers within an oecu-o~; to a&r W t i e s not otherwise avaiiable; tu

pmvide f a nriw t '~:hnoI~@ Jevelopmnt. Subsequently tbese associations inkduced emtinatiorts artd wught to i m p m rnembers' status.

tíons &en Med to follaw a simple chrún of events: teehnoloM &vame d o r c o m m d advmment-demd Por person- nej-wizatiun of personnel. More impurtiurt, such a notbn ignore the variable ti=-lag beht:wn Rrst a p p e a r e of prsonnel 'and ultimale orgmi- .mtion. %=timas Formation ant&p& an exwding d e m d in an occupa- tianrd %ea, the establishment of spialists zind conpequeni n d for 'quaflfied people'. hmiandiy Further development of assueiation justified the Found- ers?orresi&t. At times, s l w kvelnpnlent of the assoeiation suaestt-d the evident iflability of rhe assoeiatit~n to sahisfjr rwuirentents far qdified person- nel, or a f& artridwtion of n d for orgsnimtian.

Mrlfemn here insisís on a variety of possibilities. The orenization may ar~ticipate, it m- foíiow a @ven demmd, ít may be toa much t m w n , it may be too little too lote. That is, hnillerwn hi ieves that the link h t w e e n &ti-ti= work (í.e., demand) and association may be em- plotted in a vmiety of ways. In an eartier discussiun, after illustrating the impossibility of a single plot, he lis& the passibkt models (d i func- tiund) for the link leading to a successful qudrfying assoeiatíon-to achieve or consalidate status or pm&ige, to break away or react to an existing assuchtian, to c ~ l d n a t e existing practitioners, and to re- spand to utterly new orrcupational possibitities.

This diversity in part refleets the complexity of the Bn'tish profes- sions. But it dso refltxts s e v e d decisions Millerson has m& about how to te11 his story. First, he &S not accept the implicit self-interest mude1 that unifies the professiodzation narratíves of Wilensky and Crrplow. Sdf-interest is but one m o a g a number of theoret idly p- sible motives for action. Second, he uses a different strategy to as- sernble his data. Wilensky tmked at a set of fint faets across pmfessions m d rnade up a story to fit them. Capiow's modei is ekearly based on much the san-ie pm-SS, using the stories of journalists, undertakers, junk deders, md labaratory technicims. Mikrson, on the wntrary, begins not with the bafe details of first facts, but 4 t h individud nar- nitives, prdessian by pmfession, complete with s t a n M historial ac- mun& of motivstion. He lmks at a11 hís 0rtl;anktiond histories and sees tour or @ve remons why omizsations were set up. Si- he has no f u a d w n c a I model of self-intere~t to tie aU these reasons together, he leaves them as independent versions of the link from demand ta o ~ l a ~ o n . f í e emplOyS a similar sti"atem in studying the tink be- m e e n s e h d s aod emrninations.

Miltersa& mLtiysís afso reminds us of the cornplexi~ involved in ardered socid p r w s x s . Sometims we see the present as independ-

ent of the w t , a position Milierson fotfows wíth regard to profesrriond ethics. Sonretims we see the present as uniquely detemined by the past; a pmfession has only one place to go ned from where it is now, only one career to f o l h . This career model is the one chosen by Caplaw and to a lesser eitent by Wtensky. Mi i l e~ .~n , on the other hruid, generalb uses the iess-restddive idea of coritingent develop- ment. Even though the p t shapt??i the fuhtre, khere are several out- comes for any professional present. The next event after professional rtssotiation may be licensiq, emminations, or an ethies d e . The irn- portant questions are which one and why.

klillerson despairs of finding a single story of professionajimtion. %e msounding impression is of individual uniqueness, tempered by an 4ushnent to the social and e d u ~ i o n a l climate of the time.'"1s For som authors, this "individual uniqueness" is in fsk-t d i ~ l y attríbut- able to "the social and educational climate of the time." Orie such is Ma& Larson.

Larson tells the story of professionafizatian in a new way. The dif- ference líes in her use of time. For Witensky, Capluw, and Millerson, professions develop in abstract time. With the exettption of the "tern- pering" just mentioned, this time has no properties of íts o- that cundition the developmnt af pmfessions. in cuntrast, for Larson such properties are central fórces of prafessionalimtion Some pmfessions developed in aristocratíc smieties, some in democratic ones, still oth- ers under corporate capitalism and hurea~~eracy. The murse of profm- siimdization varies in each regime. The iarger story determines the tíme, the conditions, and the stntctures throngh which proféssionaliza- tion takes place. l7

In general fom, h n k stories follow not the tonvergence piut, but rather a stqes-appmaching-a-stedy-state plot. The steady state is elite status. Larsonk central suhjects are elites of practitioners, which seek personal rewards through collective mobility. There is no p&u- lar content to her genede stí3ry of pmfessionalization. h y organiza- tional pattern (association, lieensing, etc.) that furthers w p r a t e re- ward is a logid next step, provid& that it is pssibie within the larger context of the xtciety. Thus the cansa1 links are Functiond, but their mntent is detemined by the societai context.

Despite h s o n k unusual kndling of time, however, her story of professionalhtion stiI1 draws on the standard reprtory of techniques for tellíng the story. í t is useful to sumrnarize the dteniatives availabie in that repertory. First, storíes may assume a centrd subject of narra- tive and fotlow it, or they may chronide the creation and discolution of such a snbject. Stones proceed by joíning a series of specified sita-

ations with links ihat describe the snccessive resolution of each situa- tion. %se l i n k are usually h w n Erom a timited set of basic models for why things occur in suciety-fvnctional, historicist, evolutionary, m d so t>n. Underlying these links is often a single simplifying assump tion abuut why events m u r , such as the self-ínterest niváel. In putting these liriks together, social stories take a variety of appruaches to the o&r of events-making it sometimes essentjd to their ou tame, sametirnes irreievant, sometirms in k h e e n . %ey also &e a variety uf approaehes to issues of convergente and divergente- some of them rewunting the emergente of a steacly state like "futl professianalíz~tiun," uthers the development of oscifiation or imbd- ance. Teliers of social stories &o have metqhors for genedizing these stories. S o m employ the metaphor uf career or Iife course, searchíng for a single typicil sequence. Others employ more open- ended link-by-link modeis, tisíng m implicit metaphor of eclnversation or interaetion as their model for sequences.

This somewhat literary malysis allows us to separate the formal from the substantive diversity of professionalization theories. Some of the choices made in analyzing patterns like professiondization we re& as si~bstantíve-the choice of an underlying self-interest mvdel, or of functiond mUdels for links, or of p&icular stmctures (e.g., ethies codes) serving P #ven function. In past discussit>ns of professiondiza- tion, these substantive aspeets have sometintes been the focus of atten- tion. But other choices we set: as purely formal, Iíke the choice of a central suhject and a plot form, m d it is imprtant to r a g n i z e that many ineclmpatibilities among theories of professionalization arise out of these formal decisions. The "proletananization of professions" ar- guments are cIassic examples. Their central subject is professionals as an inupationai class, rather than professions qiia social groups. Yet they have been held to reject the concept af profesionalizatiun. What they have ia fact rejected, or rather qualified, is a certain version t>f the professionalization iiígument, the version in which the motive forces of the story are the externai rewads professionalization pro- vides to individual professionals. Other versions, with different driving forces, are wmpletely u ~ ~ & e c t e d . ~ ~

These formal differences in thmries of professiortalization exacer- bate the enduring subsrantíve differences, some of whieh 1 noted in outlining the history of studies of professions. It is i~nportant to recall thme svbstantive digttrences here. I earlier distinguished studies of professionr; in t e r~ns of their locus of at'talysis (individual or society) and the consrquence-S of prafessionafism they studied {internd or exter- nal.? 1 shdl classify substantive views of professionalízation sligfttiy &-

ferently, dthough a s i n in four basie categories. The b u r versians cm be dled the hnctional, structurd, monopiist, and cukurai cnncepts & p~fessionalimtion. The liinctional version was the first of these, d o m i m t in the w n l i n e of Carr-Saunders and Wilso~l, Marshdl, and k s o n s . Profession was here a mems to ccintroi the wymmetric ex- -irt-client relation. Professionaliíratíon wtls simply the evolution of stmcbral &uar.mtees for that mntro1. le

'fn the shucturaijst writers-three of whom 1 have just diseussed (MiBermn, %Yilensky, Caplawf-the funetíons disa~~peared *md the stmcture alone remained. Profession was merely a form of occupa- tionai control; the mntent «f work and the expert-tjient relati- wem les;$ imprtant. Professionalization here became an explanation of why the professians display& such diverse propertíes; the answer was that some had not finished professionalizing. The explicit focus on structure and its evolution Ied to theories a h u t the hístoricd forces driving the stmcture, and hence the stfuetnralists deveiopd the eqlicit rnodels d professionalization here analy2ed.m

The monopoly schoof saw the sane structural devetoprnents, but a r i b u t e d them not to a "natural h," but tu a desire for domi- nanee or a u t h i t n ~ . Professions were corporate groups with "mobibty projects" airned at eantrol of work. For Larson and othen, as 1 have noted, this control was interesting for its inAuenee on the status and power of professions; Freidson was more interested in its effect on such soeíai funetions aa: heating or justice. This sehoot a e r i b u t d the pattern of professionalímtion to Iarger, externa1 soeiaI processes-the rise of bureaucracy in Larson, the shift fmm professiondism to medía- tion in Johnson. The actual sequence of struetures (associiltian, xhuol, ete.) became Iess impurtant than the sequence of functions they served jidentification, exciusion, ete. ).gi

Some recent studies have moved away fmm the fmus on structural r e g u h i ~ y that marked prior work on professiondization. Bfedstein, Haskell, and others have emphasized the cultural authonty of profes- sions, returning to the Parsonian fascinatien wirh expertise as a socid rebion. By making euiturai legitimation a central process in profes- sionalization, these writers b v e set a n m enterion for the "profes- siondity" of clccupations, replacing the oid one of organizatianal simi- Iarity to iaw and medicine. As 1 nottd before, Bledstein has mnnected this cultural authority diredty to in&vidd decisions for mobifity.a

Given such diversiSr, both fonnd and substantive, it m- seem hard to consider the v a I í d i ~ of pmfessiondízatian argoments in generd. WiIenskyS regular sequen= of organizations is a fw cry from Bled- steins rise of a "metaphor and rneans" for vertical mobility. But it is

essentid that we d o consider whether the general professiondization argument can be sumssh l ty defenrfed. The variuus vieurs can in f a c ~ be synthesized irtto a general concept of professionalization, as follows:

Expcrt, white-cal& orrupations evolve towards a particuI<u stmcturd and euC t t i d form of ofetrpatiunal control. The structuriil form is cdled profesiun and cnnsists o6 a seríes oí'oaaniiítlions fw as.wiation, htr wntml, and for work. Iln its strong fom, the profcssiondization m m p t armes that these organi- xations dwelop in a ceriain arder') CuIturaBy, professioiís iegitin~ate their con- trol by attwhing their expeftise to vatues with general culhiral le@timacy, inmasindy the values of ratíonality, eErlenq, and sciew*.

This synthetic professionaiirntioe eoncept has some pwerEul suc- ettsses to its credit. As sociolo@c*\I concepts go, it is relatively coherent m d its tenns relativeiy well-deflned. in rhe stntng (stmctural) form esp ia t ty , the orgitnizations and their sequence were prticularly easy tu mwum and surprisindy c o m ~ a b l e &om case to case. The con- eept's focus on expertise referred dirwtly to general theories of oecu- palionnl eontml. Moreaver, not only was professiondization weli be- haved thriuretiedly and oprationdly, it aiso had no smdl empineal power. The major British and Amencan professiuns seemed to follow it relatively wetl, a l thoub o w n i z a t i o n - b a d pmfessions Iíke the militar); and the ctergy createti some probiems. As 1 noted, Wilensky tested the strong f o m on a s iabie sarnpfe of Ameriean groups and found great regularity in the sequence of orgmimtions.

At the s a m time, the professiondization coneept haf had some grave ditEiculties. First, it tums out that the results of WilenskyS strong furm test were largely attifwt~tai. Second, more than a d e d e of historicai case studies shows that most of its underlying assumptions are faice.

To test W i t e n s w argtiment, 1 have studied the order of eight events in 130 Amencan and British professions. My andysis spiits oe- cupitions studied into three groups: recognized free professions (about 2G each in bath America and Bdtainr; subordinate professions (again ahout 20 in each m e ) , and an "other" gmup containing variotis pseudo tuid wouid-be professio~is. The eventi ordered were:

l. First (national) professiod assaeiation 2. First guventmen&¡y spansored licensing le@sfatíon 3. First arafessiond examinations 4. First pmfessional sehuol s e m e from some other profession 5. First universie- professiond eduation 6. First e t h í a c d e 7. First natiod-fevel journa1

8. First accreditation of schools (U.S.) or eertification by asscxíation (Endmd)

The data were pthered f r m a wide variety of soumrs and were, of murse, incomplete in mmy cases. (Missing data does not, however, bim the results, @ven the m e t h d s used.) The anaiysis praeeeded by liinding mm "distances" between the events under a variety of metrics (e.g., red time, iog time) and then using these distances to establish m "order of professíonalízation." I applied a simple one-dimensional s=ling algorithm to find that order. The results were that there is pus- sibly a rewlar order among the American free and subordinate profes- sions, but none amung the Ameriean other ciategory or among any of the three Bntish mtegories."

Perhaps more importantly, analysis of the assumptiuns of this for- malization of WilenskyS approach shows that the results cmnot help but be artlfactual. Sinee there is one rnajor, national professionai as- socíation hut, in many professions, dozens of schools, it is inevitable by probability theory aione that tthe first schoot will precede the asso- ciation. Similariy, Wilensky found universie education tu folkrx sepa- -ate schmling not because it necessarily did, but hecause he included ~iniversity schmling as a subset of separate education generally. Thus, the date of the first %parate school was either that of the fint univer- sity school or that of the first nonuniversiq sehml, should one exist. It was therefore inevitable that the "separate schoui" event should a p p a r , generdiy, before the universiv x h m i event. There is in faet no real empiriml support for the strong form hypothesis that the organi- zations seen in professionaiization arrive in a particular sequence.8*

The empirical pmblems of the strong form hypothesis of profession- dization would not be so impartant were it nat for the evidence w u - mulating against the underlying assumptions of the concept itself. There are five hasic assumptions hidden in my synthetic concept of pmfessiodization. The first is that ehange is unidirwtiond; profes- sions evotve tmards a @ven brm, struchirally and culturally. Second, the evolution of individual professions does not explicitly depend on that of others; professionalization can he treated case by case. Third, the socid stnicture and cultural claims of professions are more impor- tant than the work professions do; the latter is unmentioned in rhm- retical studies of professionalization, although it makes obligatory ap- pearances in case studies. Fourth, pmfessions ase homogeneous units; what intentat differentiation they possess refiects mntingencies of the "professionalization project." Fifth, pmfessionalization as a process does not change with time; alrhough a description of history, it laeks a h k t o v of its own. Of murse p&icular writers have avoided various of

18 lnhuhicilm

t k ~5suniptí1ms. NOT~~.lheks. thh sumnwy captures the nnwrpt ;rr i t IS genrrillv id.

?lw n?tsuiiiptkm of uriidtrecthmdity h a been utiorkcd by both m- dologicril ihtrsrirts aml liirtorram The theorfsts h ~ v c come iip w(ih <I<.l>rcilv~-iuiidli/~tnn, uini pmlrldnnimt~mi to rcfir tu tlic appucnt d<.t.reaW in pnift-ssrnnul Icpitimq mti ~li tormiy cin thaa nnr? hn t l and ti, thc Ieut~inq Iieiiefitr iif ~>nifesqiu~Iism fnr thc mcnihrrr of tlir ptuíi.uions tm ihe utlit-r. fhc hisioriaris Iiiivc otu<lid niinwnnis pnb ft.rsioiiil ur psctdaprurclriori~~i p u i r p t h t hwe ~t;~lled or rvcn d i 4 un tht. Iiigii niad d ~in~fturirin~lrrriit~ici-p'iychubl rnc<liumr. clcr- tmtheriists ;in<l f i ~ i l w y surgtwnri. cntnpotrr "mders." nikbivm. Thev l u s t . stutlied u i ia l~n~t iu t i . iunotig Rrilish iiiacteenth~~ntiirg rkr*or~ tuid luiion# twenticth-c-entwy m-!el wlrkcn, end dso divuim ainimy twrnticth mtr i ry Rntrtli Juctnr~ nnd iimoug ~ a i d 4 r e b gtoiia wrkm in &nra. In short, tlterc are clrwlv a wukty ofdirec ttorir for devclapmcnt. ;d dcvc!vpmeni tcmridu dnmg mtml is hut one «E th*m."

Ti* ~aiinrptian thnt ame pmícmloni drwhpmcnt h indqmdm rfianidherí ir th~wicrrc<l irnplicitly hatt no kw stnrngly. it is tnie thpt m t wurk on prufc*iiunr cuiittnucir tu he done on a pmfrssíon-by- pmlerslon h t r . Birt m-idenre d l l i h le in this very m r k qurstions stich u pmmlurc ntmndy. Much w~rk cm subpmfiaiimis in the nwdi- cid r~mphssb~ t he inti.túcpcmlrncv ufpmfmonld dovelopmnt. m <lo ~ l io rmcs of AiwM-aii pyrhiatry ttnd soc'ial wrk. of th t W ~ U U S

t y p s clf mrg~~mrs. of Iw mid imitinting. Bookr on individumi d e s - sionu slrd nitirh uf t k ~ t time oii intrrpmfmsiod mlutionr. but mma dmur thu obvious m m l that tntrrpmfbnional rnlatiotv are potenttaily ihc ~ r n t d ícatiire uf pn~ft-ssiuniil dt-vek>pincnt.m

'thcl ammptictn that stmcturc is more imporbint thm smiP1 warlt b, lih iindtmtioniility, m vjpcct of ?he wciologlcnl thcary chal- lenged by histuric-l 4. S a w ~ l wiork on pmfesslnns, inclidtng mirch of ihc puwcr literahare of thc last d e d e , littk attcntion IU

tlic ;triitnl wnrk i h t ir clane and thc errpcrtusc 4 to do it. FreldsmP m>& is it striking m p t u n . ! l ú t c i h l litdy, by cemtmt, har emphs- zizrd the actiial wvtk ~ri<mncd ln pmrcssfons ai divcm as 1ihru-i- anahrp, ~ngwirning. pychmtry. nnd thr ckrgy, histwuins hivc shom the intlmte rcluikin tif prnfessiatd atntchire d eulture to wo* it- *U. l i w nociologml thcorists lwvc n d Irmed h m thb thpt wwk miut be thc hwtu of r txmmpt of proksslrmai Jmclgiment.*

Ipnoring i n t c m l düierentiution in pfersions hm helped the pro- kiunilimtioti rn-t simplify h u t it h u to explain. But mrent HV& i i n p k that I ~ L Í ausumpthm, tw, is (hgemur. Sociolqists

themx'kes how mitilnitc<l unalyses uf diflmeiwifs in tnt- si& pn'sti~p. in lo<.atir>rts nf w~rk. in JLCLYSS tu prafcrviond p r r . \Vhilc saiulitgists Iwve n i~ t i t i neiirml r*>nnwtd t k r r intmiiil p t - tr-rnc hi ptttrrtr cif l>tilftb~~itXK~l ti<8uclnpment. I i ismtiasts hiive d t ~ m w, in stiidn- nf thc k-giil yn)L*aion. uf iwgiticr.riiiy. ul mduim. Ttic d ~ r l o l ~ n c n t IIC intcrtml ditfr.rtw'c1 is Imuntl dinvtlv tn thc dtwclnp- tttcnt uC prufrssioniilism.)

Finilly, the aísuinptinn thpt ~ ~ d f r a t i a n 1s a E P . I K . ~ p ~ m r urithoirt uny history of its own tuu kw rhullcng+d fmrrliilly ty ihc siciulo>nk-ai tk~r is ts themwlvm. priiculiirlv j~ihnwn riml liuawi. &ah nutcd thrt the inmosfng invhlvcmcnt of the st-ate reshqwd p m fcsrionuli7utiun. ;u ditl thr rciiwd drif ttlwodr t>iiwilum~k pr;ictire.

%sr I csmn were npnled as h g uvc.ttfuc I iy k>th the histnrínns md thr. ~uciolt>~isti irtiidving Gmtincntnl pn)imsiurw. for the clmgrs rl&bed ly Liuwm uncl Juhn~m I~mrpCht the itnusud profciric~ni d Englud 4 America mote in line with the mak l of pmfr~~ionuliirn Icirig drimirnnt in Fronrc und ~ ~ y . ~

Onhal*ncc. thm.theevklenrcargtmfiwannr,yrpmchtopm- f m b n d cbdqmwnt ta m p k tbe genmd pdewiundbtion con- cq~t . Thrrr is. d mum. ~writ dlvmity ín jwnfcsrkmdization t\ini- r i a . Mudi oí'it. as I hmc iugurd. i l Formal divenity. Them urc mmy thmricr r h i m i n ~ to I l c gmrrd thtvlnes rbout pmifnsiilid devchp i m t thnt are in fact rpecial t hcw ind th i s~w thnt m u f i t , and c ~ e n the gemrrJ tl>eories o k n puse their aalilyscs in furdnmrntdly diHmnt riarrnttve ternis. And them are wirle d i l n * m r in the suh- s h r m uí theJe p ; e n d tltpories-in Lhc drivin~ mmhinisms thpy pmit. fn the pancm ofdi~nt ion t h q dopt, in thc putkuiar rtmc- tures tlwy crnphiisln' Yct inurt prurcJsint~niiitioa thrwirs falknv ui commnn appru~ch to t!uir xub~ect, w b t 1 dkd the synthetic thrwy. TMs synthrtic t1uxn-y. depite thc strung support thot m y case stud- ier @ve it. lw profoiind shortmming. A rcriocio empirical test mjem ¡t. More impwtantly. its t>auc ousiirnptlons huve al1 Imn ovedmwn by rcfcnt empif id m&. 'Ihcw p m b h irnply thrt t k case study mppurt Ir more illuaory thon d.

In thc rliaptm that Tnllow I tvill popoi~ m altmmth h m y tknt merses thc pn>blcmatk assumptions of pmfemiunnliutimi theoriar. ThP alternative ;wiimpHons Iwgin witfi a &KIIS on wwk. The antral probkm with thc nirrent o-pt ofpmfmionai~caiim is its focur on srn~.him r u t k thin uark. I t i s the rwntcnl of the p ~ i o n s ' work t b t thc r a ~ e studics tcll ris is &angina It is control of wwir that brings ttie professioas into mnUd with corh ather nnd rnnken t h r histories intenkpcndent, Lt is ditlemtiation in typa ufwork thrt &m le&

to sé-naus d&entiation within the professbns. By Mtching h m a fwus on the wwizationd sbc-res of prtsfessions to a focus on m u p s with common work we repiwe seved of the problematic as- sumptians at once.

"hrt central pheuontenon of professiond iife ís thus the link be- Meen a prdssion md its wrk, a link I shdla i l jurisdiction, To ana- lyu: pmfessianal development is to andym how this l h k is created in work, h w it is anchored by fumal and idormal how the inteqlay of jurisdictjod linlrs betweeu professians deter- mines the histoq af the individual professions themselves.

Cases af Prdssiond Devefopment

To illustrate the cemptefuties that any theory of pmfessional develop- meut nust handle, 1 shail give in the remainder of this chapter some e m p b s af that p m s s . Them examples represent the much I q e r eolIectiun of case sh&es that I am trying to eqdain. Su& e x e m p b vigneRa e m M y a eompromise between severel ways of approaching the data. A pi t iv is t would redme d l these histories to coded facts and present them as d e p d e n t variables. A theorist wouid present an exemplq case at ¡en& md delbeate the meehanisms ai play within it. r wish to &nce, these c a n t w imporatives. On the one h d , the divemity of the pt-fessions m w t s a narmtive presentation of con- trating cases. On the other, we must ahstract from such cases and generate iestabke Ideas. My compromis is to illustrate the pmblems of expianation with these brief p i c t u r e ~ . ~

Let us belgn with the familiar case of u r i c a n d i ~ i n e . ~ 1 Like ntany Amen- pmfessions, e had two waves of professiond- izing activity. The first, which be* a Iittle before the Rewlution, saw the founding of a f i eady schools, the passage of some exclusive state licensing laws, and the creation and empowerment of some Id and state sdeties. The JackFonian era struck down this exclusivism and opened the gates ofcompetition. A variety of sectarian and fofk healers apperued. h o n g these were the hammpaths, who espoused, among other novel ideas, the practiee; nf not kiiling patients with treatment. This pwt iw, and the g d resnlts that attended it, made the h o m paths mther h g e m u s & v e d e s to "regular d c i n e . " There en- s u 4 an intense war over who hd the nght to cure people. Each side c i a i d the leetirnacy of science, de&& the &&y of the puhlic, and a t h k e d its oppanents in e-ditorieSs and speeches. Thr: regulars devised exelusianary e t h b rules q u i r i n g a dylng patient to dismiss an at- tending irrtsgulm as a mdiGon of their own attention. In this, its

&h& hour, reph medicine at k t saw fit to found its nat iod as- &y the late njnetwnth mntury, the regulars were fortifid

bythe a- wientifte &cine from Eurape. AIthou& wnafned with &ngnosir, etiobgy, and pathology niore than with t ~ a t m n t , Euro-

a few spectibcular therapeutic successes that pawer. Thus minforctrd, the n?gular?r started

their ethics, and be- tu refonn their hgok.. Fmm the h o m p t h s they had learned to avoíd heroic treat- d the twa graups united mound the turn of the eenhiry to

fbt off new oubide tbreats-the w t m ~ h s -od later the chiroprao m* 1s a wh*l+nd of rehnn b m above, the nebuIous world of príi-

4 4 s b f s , ptent d i c i n e , and uaregulatd practíce qmished under the clear omization radiating from a powerfuf, na- u@& uníted pmfession. lñe mmmunity general hospital, the &un- w n orwiuttion of mctdeni medicine, d e v e i o d i-pidy. M&ough

f d I ofsbte intemention, A m m medielne pmfited irn- f o r m d o ~ of public arid private in cheme~, itg inam and prokssional h i n m i b -

tary it M = s u d a position of socid praminenct? and p e r euwied &mu&ut the occuptiond worId. Included in its vast organizationd empíre wre a host of s u b d a t e pmfeaiond groups,

%e case of Amen- medicine shows h w eomplímted and inter- wwen are the questions about what prufessions do and how they in- temrke. If ane aims to "6d tfie orígins uf" Amdwn median#, then the h w o w t h are an outside follce thaá enters the picture, fights with &e p q ~ n i s t , and then unites with it. But sueh aoi interpretation i w m s &e virtud dissolution of regu cine under th nhn onslaubt. The "duing of hesling*' a free-foz--&. tagonist itself is not a mnthuous entity. Development, &vi% and interprofessional reíations are bound up together.

%e medid profcssh& absolute ainhul of bodíty dis required de- femive work on a nurnber of boders. Perhaps the most important of thesú borders was the hazy une between bodity and mental aifrnents. Nere e m r g d a m n d pmfessiod group, o ~ i z a t i o n a y a pari of niedidne but hteUectually and practically separate from it. This sec- ond sketch, of bncan psyehiatfy, sshows again how complex and in-

is the web of pmfessiond developmnt. (1 will @ve a sus- *& +sis of thif ose in chapter L0.P

Ps~hiatry be* when a group of enterpdsing rnedicd reformers med in tbe early nineteenth eentury that madmen ought to be re- mmd &m &e jurisdidian of the legal authodws and plzlced under t b t of the medical professian, Madmen are &k, they said; @ve them

to us and we w i U cure them. A new theory and therapy justified the shifi, arid p~+vite Mies and state le@sttihrrcs were sooa dotting the cauntryside with insane asyiums. Psych im was the profession of the superintendents of these instihtions. (Nonsuprintendents were finaliy &mi@& to the o r g a n i d prafession in the 1880s.) Like teach- ing 2nd wid work, and unlike its parent, medicine, psychiaw thus amse out of lui organizational &m-t-he hospieal fOr the insane. An

iation, journd, and oAicid p ~ c i p t e s sprang sirnuItaneously into being in the mid-¡M&, about the same tíme as the APIIA was faunded. Thruu&out the iatter half of the centuq, psychiatry was an elite pm- fession, its memhrs exceeding most of their m e d i d bmthren in in- comenie v e r , and prestige. But the latter hdf ef the cenhrry &so brou& decline. The earIy hopes of cure proved illusory; the psychia- trists p d u d l y k m ttdministrators of custodial warehouses.

Memwhile, the jundi&on that would ultimately become psychia- tvS was b i n g explord by other píoneers, the neurolMsts. From their b l d y bsptism in the field hoiipitaIs of the Civil Waí, these men emerged to became general consulting speeialists, helping their m&- cal colleagues with peqiexing cases. They took h m other physicians üny patient whose othenvis untreahble iltness couM somehw be re- lated to "nerves." Under this mnveniently vague heading, they rol- i e + d the mi&& whase redcitrant iilnesses imouened the new e a - . .. corey of medicine. Heavily i n f iuend by German medidne, they were ske~ticaf of treatment in ~ e n e d , arid whea cures were discovered. as - fm ;he "nemus" enrfocrine diseases, they at onre retumed the &S-

m e s to general d i c a í j u d e t i o n . The neuwiogists developed their ascociation, journah, and univemity teaching positions during the sec- ond wave of medid professiorializrttion,

But they smn fowd themseives overvvhelmed by the ho& of "ner- vous" patients ather physicians referred to them. These patients had few hut peqlexíng organic symptoms; for the most part the problem seemed to be ''in their minds."' h a result, neumIogists and psychui- trists hegan to handle this junsdiction together, the neurologists defin- ing the patients by their tack of response to standard treatment, the psychía*ts seeing them as irteipieatly insaile. For about twenty y e m after the tum of the century the iwo WUPS interpenetrated. Then in a suriden shifl, they divided. The tenn "neuroI@si' cante to refer to organic physkians generally wrkutg in ho~pitafs. Psych*sts took over the neudo@&' oId p i t í o n as the ouwtient b d e r &u& of the medical pmfmsion, handling the symptoms and diseases that

not quite red. At the samt. time, they began to accept direet refemfs R-m &e lay ciamrnunity.

InMuctMn 23

m duwt r&ewaJ.s reflected the psychiatnsts' rapid, entreprenuer- arrrras of mi& control long domina& by otber

he heip of a popular front orwization, the Nationd kwime on Mental Wygiene, psychhMsts in the twenties tried to eizft m a m i wer juvenile delinquency, alcoholism, industra unrest,

stnk, and numerous other areas. This brought them into vio- eng wmptition with the ciergy aml the 1aw among the otdítr pmfes- -b@, d ~ c h o 1 ~ and mial wr>lk among the newer ones, InteiIm- &jyB rhe psychiatrists routed al4 hut the law, dthough theír n u m b wem w srn& tu take more than a supervifory mle in the jufisdictions tt.lay Tfia pmfession continued u-ntmtled until the sudden egwsiom ofhrnanrrl for psyeh&hempy ia the 15470s found it so under- s&d th.at pswhofw and mi& work pen*ated the third party pay- m n t sehemes that had so long pmtected its munw+.

%e sbry of psychiaby is thus a d&rent one frorn that of mdicine generdy. The professíon began 6 t h an or@;anization. i t w h e d &ron& tfie formatítitis of pmfesiondimtion-4ation, journd, d + i n a d d e . It c h g d jitrisdiction ahust wmpleteiy over rts IWyew hisbry. Ag& we see that the cen td questions of h m pmfessiuns dwehp are tied up with questions of inte~rofessionaf rehtiuns and the mnteat of pmfessíod HMQ. Pmfessionafization occurs, to be sure, but in a context that helps determine its murse. A campmhen-

f pmfessional IIfe musc: deal with these compiex h of wmpetition d ín teqmfwiod relations. Thís can be re clearly in &e Britísh professiom.

Unlib Ameriw pmfessiuns of the b e eighteenth century, their e o n t e m p d e s in Engfand were not hmhated by a mehuplis distarit in spae, but by tfaditions distant in time. Law in particular eould trace its ofigins to the personal councih of the f h t Piantagene&." The sehmls and asmiatíons of the Bar, the Inns of Court, had ktft their recurds so long before that no one knew how old they were. Even less was known about the Inns of Chanmry, in which were collected many mmbers of the lower b s of the pmfession, the ancestom of the present soIieitom. %e pmfession had an intrieate hierarchy, as befit- ted íts semio@&d onlpns, bu three Ieveis in each of a numbe dístú>eished by function, the that of ord argument, the third that of mpmsenting or apvar~lg for a lirigatnt. Eaeh court h;ud its own junsdt&ion and its own narnes

, basristers, d wikitors in w m m kw; a(tomeys in e q u i ~ ; judges, d d o s , and rts of AdmÚaity and &hes. @he laft was

24 Intraduc*bn

the chisf ecctesíasticat cuuit, whkh until the 1870s had juri&&on wer all fam& ma&ers otfer than propeftY.j

Tke carnmon km and equity pfmsíonr of &e late ei&teenth cen- tury were ia se- more a p m m m than reality. %e Inns of Court, whicfr had at times been vibmt, active orgaabGons, were at

rs and &rs leammi theír UIO& on the job. D i d p k e was exercised, very m b n d f g 5 by the courts and the & i n & ~ @ v e committees of the Inns, the knchers. Despite this e m m t iadolence, the wmmon hwyers of this penad h;pd jwt won a sigaal profedonal victory over the be~er-educated and more famally professianat dactors of civil faw. U& the leadmhip

mon law judges, they hacl over he entire wmmedal j d i c t i a n it pa& of common h.

%e ~ m u n e of the m s t e r s was upset by a mvolutiun fmm belm. The aaomeys and fofititars built in the early nineteenthui centery a national asmiiltion {really a metn>poliW one, far mast le& bus&=

), which undertmk what we would n m mi1 seriow It mm&M a f m a l ~ ~ n t i c e s h í p

r i d pmtitionem, i m p & professio tions, and began a s&ous and careful pmfessiansJ tiougtit far, ami won, a monopoly of &e newliy Iuerative business of eonveyaneing ( p r o p r : ~ transferf. The brristers reswnded by consali- cfating their own absolute mmpoly of verbal pleading, whleh had been ganted several eentuds b&re over the intense objectiws of the lwer b w h w , 2%- removed their fast wmpetitars, the mori-

ts, cansofidatmi the jdsdictions d their courts, and the old rule tbat di judges be kristers. As for professiod-

ization in the nrodent sense, they did It?ss thm nothing. By the mid- ~ e n t i e t h cenhrry there was sti f auhr ized barnsten, no na t i ad ascoeiation, no cen a y . The educationd activities of the Inns continued hougb the English uni- versities naw gave &helor's h e e s in common law; passing the bar was stig a xnatter of sitting ternts at the ims and endufing a vague

vas a natural mne oí expsion. The e w s i o n had a number of inter-

,&g effectii. First, the siow growth irnposed on the profession by its m S&& S m m t that it was ovemheImed by the welter of ~ m ~ e d estate work that was genemtd by business expan- m, In m-uenee, iis chief junsdktiond monoply, mnveymchg

b;rd by this century h n delegated to a subardinate profesdod m u p s tIie m a @ n g cleiks, who did the wark under the very Im ~pem&ion af cobtors. This i n t e d subdhat lon of routine work is a cbeter is t ic sáategy of professi g more jurisdíction than

behg the best exíanple. Fmrn t h outside, however, competitb Gom a n e s

rs ta maneem how, why, md whether they were achiafly ni&- me. In the area of advice and corporate r e s a d d n &

* w w a t s and colícitom remhed en uneasy truce. Each had its owa m e hirf; thk area between was often one of eadict. 'Fb -untan& dmei& =tia& snd i d orgaoiz-aeons h u b

w d y afuund 1880. %ir journai dates h m the wne period, as o. sbícr discipknq p d e s and theú examinaaons for en- -. Amuntuy: edueation was supervi @d smiety, dthough ít took plarx? in the ~ ~ o f ~ i c W ehrkship with a m m ~ r o

mIieitom, the chartered -untan& in fact had far more business than their s f w growth could hande, and soon wem b m d to tolerate at le& one group of less educated and certified mmpetitors, the Incor- m e d Awmtants, @he continued exclusívism of the Ckartered ami f ~ - p o f a t e d A m t a n t s means that many other group of aaount- atlB are o-& outside &ese Ieaden of the prdes9ion.) ln the pres- at a a b r y , the profession underwent a further change, in this case a

numkr of individuds and smdl erships doing a mmpletely dif- ierent local busuiess.

case of Endish accaunting

a ~ d surgeons, md meatd al1 the pmmr annbutes of professionalísm in s h r t o&. W a t redly detemind the history af the professim was the de-vebmnk and shift of its jundiction-frm bknrptcy to audi*g, with &ud e w s i o n into cost m u n t i n g and n '"managemnt semices," Here, too, we see a n u m k of other teristic deveíopments of profesGond life-the competition fmm be- low, &e @uaí malding of proftssion to clientete, the mainten- of a stmte* h d m d mono~ly. Yet at the same time accounting showed its wiilingness for h d - o n mmptit~n-with law over the degnition of pro&, 4 t h Iaw aMf bls ing over the juridietion of business advice,

over íhe pruvision of staíF services. n e r e is much more here than is told by the simple image of professiondtzation.

But even moro houbthg quest;ioas about the way pmfessíans de- velop and internefate &se when one leaves tha familisr Angfo-fheri- t-an s u a s s stories and studies either the cantútental professions wíth their civil-servattt character or the failtd professions that litter our own history.

In , the ncw effects arise because pdessional Iife is over- shadowed by the state. While indepndent competirion still takes place, d indepdent professiond evolution OCCUIS, both aim im- mdkteiy at the zhiwement of certain status wírh the stake. The abdute, cenhalized, and ratiodiztrf c-er of French govemment I d it to take a ddsive role in orgaiPng occupations both before and &er the Revolution. As a resuk, developed professíons a@ tend to look alike in stmcture. At the me, pro~oprofessSons tend to be ig- nored dtogether; things u iza3 by the shte e m u a b ~ r t m t .

Thus, the French legai , whiie in same ways reminiscent of the Endish one, differs fmm it in esseatial ways.= iin the ñrst place, it is bmken up into a dserent set of jurisdictions, with diffemnt rela- rions between thern. (J am here prmn&g t 197% fom. The fusion of that par meqed meated a n- group of cotfs&)urid@ues ou ea&, m i n g their I V O ~ woll baek into medieval times, are mughly andogoift to bsrn~ters- They are into bars under ecich dif- ferent caurt, aMf their W t monopoty of oral pledhg in many mur%

a hrrnril in the Mapoleonic Code. But they are unlike the gn&h m in mmy mys. T h q share their seUldisciplínary func~on with rhc courts, as the B ~ & h have not sime the Middle Ages. Indeed, t b ~renrh mortf have on oecasion reorganid their bars completely.

&rr aras ablished aftogether during the early years of the Reva- R Yd was reinstated wíth some reluctante by Napoleon, who de- d m. The auoeats are also unlike the M s t e r s in their iremcnt of uníversi* le& ednaiiom and b r m d at tendam at t. requirernents for drnisfion to the bar dating frorn befm the mth wabry . Under the Old Regime they s e l h if ever beame os in hi&r conrts, and in the madern French profession the mag- tx are a se-te group with separate educationd requimmnts. is pemíy tfte opposite of the British situation, where barriste= ~palize the bench in the higher couris. yoad t k a w a t s , the French legal pmfession tooked in 1970 as d no history. Its rnajor b-hes al1 had the same siructure and d tfiat stmcture to the lucid cWty of laws governing public oíñ- % various branches were separated by jhdic t ion . The aeods nred for their elíents; they filed fonns and motions and shep- ed the cases throu& the court. The notaires recorded formal m a t s and eonducted the transactions so recordd. thus control- narriage, property trander, probate, and other jurisdictions con- d by attorneys in Engiand and hwyers in America. Huissiers d otfrcísi papers and levied executíons, b t h for courts arrd for ita paraes, combining what in Arnerka would be the funetíons of SS senrers, baiiigs, and collection agents. G r e w s kept court rls andr other oíñcial dwuments, pMcuIariy those pertaining tr, &esses. AIl of these iurisdíctions were fomaiized in leeislaiion or

w

re. So afsa was the profasiond stnicture. Each group (or ordre) - orgsnized into local (%dementale), regional, arib natíonal &res. These M i e s were oiñcialiy charged by the state with keep- ; remrds and rolls, with originating disciphnary &ion and adminis- %ng murt regulatíons, wíth running the we1fare systems far the %, arwlr with governing conditions for suix>rdinate workers. The

S af-t set educationd reouiremnts far the various orden. Perhms

th LPtr ir f lía-

n& afkníshing aspect of the rwlations of these professional ps, te t b AndeAmerican observer, is their formal pmvision for

9 p u r e k of ofliice. Eaeh mernber of these groups of oifciem min- bought his position when he entered the pmfession and sold

or h u e a t h e d it) when he le& it. The pricct was normalfy from four Peo tímes tbe annual imome. The state thus had indirect control

W@P tht? number of these officials, as well as over their be ha vio^.

6 ea5u& to emb- &e pkmmnaa of p m f e s i d &be Wo aro S- h h M wíth &e s m m af d i - , ín lar; tf-rt we k r ~ t the

w p t i o n s thrir have & a p v d . Some have gone because the e h n t i o n or technalo~y thai crrratlwl them has disapwmd, "íb && profwions and pmtoprofmsions4i~tchem, agenk, sur- geons--art: one such example. Had they developed b m l d g e that && byond the wr ld of the rai-, they might have s u f i v d jb Sut dispatching did what we now think of as opera- ti- remmh, even thou& its central task was esst.niially under the finsdictiun n w heId by that pmfesim. Because they !acked & s e - tion, d i s p t t h n && witb their tmhnolor2y. h o t h e r such gmup are [he ithierant ente*em-musihs, dancing masters, síngúlg tea&-

S-whose ~ a m b m have been defimated by the ~ e n d b t i a n of en- rtainment t b u & thct media. coum, 'trut only &ron& M m g a foudt ion in the profession of lblic &d t d i n g ' ) = A & case of pdessiond death is that of the psychoI@cai 4-

m%. Mediums Bou&h& in the larter nineteenth eenhtry as t'tre pro- f e s b d e m w a n t of spinhalism. After the turn of the wntury,

, hmfar as it s u r v l v d ak 41, an ormizedi chnrch uf the &erge, complete with eongre@ions and mñnlsters. But for

banner was carried by a group of mediums several hum-

The d i u m ' s skitl was her ability to encourage, through passiviiy d o p n m s , efFective eommuniation btween her audience and the Wi-e of the s p w b d wrM. The first foI10wefs of the etJ1"mg be- in io r6e I"iap, &&u& Mesmrism, Swt?denbo~ism, artd a va- ety & &her predecessom had prepared the way. Tlie weekly journs)

ot' the mdums, Bamr uf i&&, appeared fmm 1857 to 1W. Tho Medims Mutual Aid Society, aimhg at inswctim and support of aii mhg mediamistic powers, was founded in 18e0. A variety of eBent turd mpwrt g m u p such as th0 Natianal Organimtion of Spif iu is ts

~ W h d brut.8~ amd discussed, in vain, the problem of regulating the ~whma An o~~ s c h l of d i u m s h i p was founded by Morris

at Whitemter, Wmnsin. It is i m p o b t to redize that d i u m s h i p fits the basie definition of

profeSSion vmy well. It appiied a set of esoteric skills to mpafticuh

mr. Cer tMy it pos~ssed al1 the organizationaf parapheraalíil af a mksion-schwI, ~ w i a t i o n , artempted rewkíatian. It is imp-t,

trxl, r d that many w e l E - b w Amentans ptmnized mediums aPld thar spWUism was p e ~ e i v d as a kind of "scim- rehgion. As R. L. Moore has pointed out, niediums enabled people to under- take e e r d=i&am withuut impueing &&ng siates of social &m w amming pemnd responsibility, It was a jurisdiction that psy-

.Ut fn&odu&on

ehiatv WM later to sturnble ínto, ard indeed a number of psychiatryk &y htt tes w a e fou&t with d u m s ami their descendcutts the s w b d i s t bdem.=

fn reft.%et&g &ut the deveiopmnt of professions, &en, we musa deveIop m w e m that te11 us why inediumship grew the way it did and why it di& sa quickly. The mswers that spnng to mind are not very heJpful. It u3 useless faying spi r id ism was a ridículous waste of time si- the d u m s simpty couldnt deliver results, Neither muld nine- tmnth eentury n~edtcine. Nor is ii h e w I to identify '"external" faetors --th rise of s e i e e , the liloemk-ing of Protestantism, the r of the psyche. For these are di intimately tied to other ntmpeting professions-the clergy, the pfychiatrists and neumlogists, the iiea-

dernie psycftubmts wh5 took over psychic r e seah . So that even while a d e l of pmfesstuual development must take aavtunt of such externd faetors, it must dso see their direct embsdiment in inter- prafessional relations.

These brief e m p f e s show fome of the bwathtaking diversity of pro- fessional 1%. It has been easy to mistake Americao ntedicine for the paradigm. In reality the professions are a diverse Iot-winners and losers. puhlie otlicials and private individuals, aubcrats and subordi- nates, Many a profession has gone from mjp to riches, not a few the other way. Many clñímants have never found a niche in the systern at all. Yet df these are a paft of prrtfessiond life. Beyond this &ersity, these e m p l e s show how the developnrent of the f a m d atributes of a pmfession ís bound up with the pursuit of junsdjction and the best- úig of rival professions. The o m M o n a l farmdities 5f pmfessions are meanin@esf unless we uudemtand hei r context. This eontext al- ways relates bmk tu the power of the pmfessions' knnowbdge systerns, their abstracting ability to define old probbms in new ways. Abstrae- tíon erisbles survivd. Lt is with abs-ion that law and m u n t i n g hught Gontally over tax adviee, the one becanse it writes the laws, the other because it defines what the prescribed numbers meari. It is with abstmtions that psychiatry stob the neuroties from neurology, the Astlidetiow of its f w y new Freudianism. It is with abstraction that Amen- rriedieine claims al1 of deviance, the abstxaction of its 4-

Fhallp: these vilqienes have inboduced some of my cast of c h m - ters. Much of the book ínvolves theorerieal statements that malre it easy to forget the h i s t o d events they abstraet. Tu me these events, case by cxrse, profession by profession, are t)le test of the enteqrise.

mnat build an argument that work in every case. 6ut one must "jld arr. afgument that mrks for rnost. Case studies of professiom

fx>& tbe raw material of the theary and the ~ludience that says k m b s up or d m . It is important that the reader begin tu make their