The conditions of many workers are largely controlled by people outside the occupation. For example, management controls the basic framework in which factory workers carry out their jobs. By contrast, in what are called professions, such as medicine and law, the professionals collectively and individually make many more of the important decisions about what work they do and how. This control over the work serves to increase wages and status. A profession thus can be understood as a way of controlling an occupation.
This view of professions is different from a traditional one which sees professions developing because of the innate characteristics of a type of work, such as the nature of disease or of learning. The trouble with this view is that it ignores the dynamics of power in which professions develop and perpetuate themselves.
Professions must be understood in relation to other groups in society and power struggles between them. Different groups have different resources. Capitalists have control over the means of production. State elites control the means of legitimate violence. Professions are founded on control over skills and knowledge. They use this control to extract resources from society. In other words, professions are engaged in an exercise of translating skills and knowledge into economic rewards and political power.
Professionals are different from knowledgeable but unlicensed people. A knowledgeable person relies on persuasion based on evidence and arguments to convince others. Professionals by contrast do not need to convince others (though it can be useful at times). Rather they rest on their collective authority based on occupational control. If professions have a high status and exclusive control over services, clients assume that the professionals are competent.
What is it that professions control? Basically, there are certain things which ordinary people might learn how to do themselves but which professionals claim the exclusive right to do. For example, in most courts only certified members of the legal profession are entitled to represent a person. This right of representation does not depend on tested superiority in knowledge or argument (though that may apply sometimes) but on membership in the profession.
One of the key services provided by academics is teaching. This is offered not on the basis of being a better service than might be given by anyone else, but by control over the offering of credentials to students which is vested in academic institutions. Most academics have no formal training in teaching, and many are mediocre teachers or worse. Undoubtedly there are many non-academics who could teach students much more effectively. But the organisation of the academic profession ensures that it is appointment as an academic - which is largely controlled by other academics - that is the basis for becoming a teacher in higher education, not proven competence and effectiveness as tested by an autonomous agency.
Powerful professions hold a tight monopoly over the services they provide. Their clients have no options. In many cases it is illegal for non-professionals to practise, for example to administer drugs. And it may be illegal for 'clients' not to acquiesce in the services of professionals, most notably in compulsory schooling.
The monopoly over services by professionals is often accompanied by a doctrine of free choice. For example, a sick person can choose a doctor (but not a non-doctor, at least if medical insurance is to apply). Undergraduate students ostensibly have a free choice in obtaining their education. But degree requirements militate against 'shopping around' to obtain good teachers. In practice most teachers have a captive audience.
How do groups of people in an occupation go about establishing or increasing their control over their work conditions? There are a number of strategies for doing this, and they are not mutually exclusive. Each one must be seen in the context of the power of other groups in society.
Establishing a monopoly. The key to becoming a 'profession' in the first place is establishing a monopoly. All practitioners must be members of the profession. This means that practitioners must be brought into the profession, or alternatively that non-members must be restrained from practising. This is called closure. Outsiders cannot be allowed to enter the field on a casual basis. An example is the takeover of control over childbirth by medical practitioners and the subordination of the role and status of midwives.
State licensing. The occupations traditionally seen as professions - law, medicine, the ministry - established their monopoly through a relatively drawn-out process. Today, the state, with its power to license activities, provides an easy way for an occupational group to monopolise an area of activity. There are many things which people have traditionally done for themselves - if they wanted to - which suddenly become illegal for those who are not registered. This can range from selling food to driving vehicles to laying tiles. The key to state licensing is not any intrinsic requirement for restriction to specialists, but rather the political clout of the group seeking licensing. The areas which are so licensed vary greatly from country to country and, in federal systems, from province to province. Establishing a legal monopoly is vital to most contemporary professions.
Monopolising resources. Professions organise themselves so that non professionals have no right of access to goods and services which they might otherwise be able to use themselves. Often this monopoly is enshrined in the law, such as in the use of x-ray machines. In other cases exclusion is maintained by standard policy, such as the restriction of borrowing rights at academic libraries or of the use of scientific research equipment.
Training. If all new entrants into a profession are given training which ensures conformity to the standard way of doing things, this promotes professional monopoly. One effective training method is apprenticeship, which was the method used by the medieval guilds, precursors of some modern professions. Professional training often includes initiations and rituals to bond recruits and create an aura of insider knowledge.
Restricting the labour supply. The power of a profession is increased if the number of practitioners is limited. This drives up salaries and prestige. Labour supply is most effectively restricted at the training stage, by limiting the intake of students. It can also be restricted by limiting the number of licensed professional positions. The labour supply cannot be limited too much, since this may stimulate the development of a challenge to the monopoly by rival occupations or disgruntled clients.
Knowledge base. Many professions stake their legitimacy on a particular body of knowledge which is claimed to provide a unique basis for their ministrations. Training in this knowledge is made necessary for entry into the profession. Once established, a knowledge base unifies the profession while ensuring that outsiders are not easily able to challenge professional activities. The knowledge base helps legitimate the activities of the profession.
Professional ethics. Professions try to increase their status by creating the impression that they have a high ethical standard. The myth of high ethical standards is maintained by insulating professionals from external examination. The establishment of professional societies and methods for 'self regulation' help in this. Official societies and codes of ethics act to dampen any public discussion of problems in the profession. Professional incompetence is dealt with internally and as quietly as possible.
Furthermore, being 'professional' is generally interpreted as not being overtly political. 'Controversial' work and statements stir up public debate and potentially open the profession to scrutiny. Hence professional societies and professional ethics provide formal and informal strictures on radicals and 'stirrers'.
Professional ethics often encourage professionals not to openly advertise their services. Advertising might stimulate competition and comparisons between practitioners and help undercut overall professional control.
Discrediting alternatives. Professions are seldom unchallenged in their monopolies. When there are alternative practitioners or methods, these are often attacked by professional elites. An example is the de facto black list of non standard cancer therapies compiled by the American Cancer Society. The standard methods of surgery, radiation therapy and chemotherapy require substantial injections of medical expertise and hence increase the public's dependence on the medical profession. Many of the denigrated alternatives use common substances such as vitamin C and hydrazine sulphate and hence are threatening to professional control.
Academia plays a key role in the strategies of many professions. Academic training and degrees are essential in fields such as medicine, law and engineering. Controls over entry to such courses provide a major avenue for restricting the labour supply. Professions often prefer to shift control over membership from their own courses and examinations to higher education credentials, since this transfers some of the costs of training from individuals and the profession to the state. In addition, credentialling through higher education potentially offers a better public justification for restricted entry, since the prestige of the academic 'sorting system' is often greater than a profession's own system.
Academics also play an important role in strategies for increasing professional power by providing much of the knowledge base through which professions legitimate themselves.
It is worth elaborating on the use of academic credentials as screening devices for entry into the professions, since the credential system also plays a major role in slotting people into occupations in corporations and state bureaucracies. I can do no better than summarise some of the points made and documented by Randall Collins in his important book The credential society.
* Little that is learned in formal education is relevant for employment. Most job skills, including managerial and professional skills, are learned on the job (including apprenticeships).
* Requirements for credentials to enter particular occupations serve less to guarantee skills than to raise professional status and select entrants with the correct social skills.
* Grades at all levels of formal education are not good predictors of occupational performance - except of subsequent academic achievement. Grades are linked to occupational success by their certification value, not by their representation of any particular skills.
* The main content of schooling is middle-class culture. Credentials provide a mechanism for legitimating selective entry to privileged occupations. In particular, credentials limit movement from manual to nonmanual occupations, while gender is used to limit mobility between clerical and managerial positions.
* Increased formal education has not increased social mobility, since parents are able to pass on 'cultural resources' - the social skills to obtain credentials - more readily than economic or political resources. In struggles to get ahead, membership in a cultural group is a key resource.
* The work of managers and professionals within large organisations essentially consists of political manoeuvring to form alliances and create suitable social perceptions. This work can be called 'political labour', and is part of the 'sinecure sector' of the economy. It is built on the surplus provided by productive labour in the traditional sectors of the economy.
* The United States, with its large size and wealth, relatively decentralised government and competing ethnic groups, has had a volatile and competitive cultural market. This has led to a large sinecure sector and enormous credential inflation. Higher education has expanded to accommodate this competition and inflation, drawing on demands for equal educational opportunity and on the expansion of professional and bureaucratic employment.
These points give an idea of Collins' perspective on professions and the role of formal education in protecting their privileges. Professions are systems created out of a struggle for power, and not least among the resources used in the struggle are credentials.
Professionals may use the various methods listed above to maximise their autonomy and status in relation to other powerful groups, but the methods are not necessarily successful. Different professions are tied to different powerful groups. The tighter the ties, the smaller is professional autonomy.
The clergy is very dependent on the church, both for salaries and for opportunities to practise. Ministers are given considerable autonomy within their ministries, but that autonomy is strongly bounded by established beliefs and practices. Professional knowledge in the ministry thus is closely tied to the institution of the church.
Quite a number of professions are primarily tied to large corporations. This applies to engineers, advertisers, accountants and journalists. When a major section of an occupational group such as engineers is employed by corporations, then even those who are not - such as engineers employed by governments or academia - often maintain a primary orientation to capitalist values.
Professions that are tied to corporations do have a professional identity, but the professional identity itself reflects capitalist values. Advertisers for example unquestioningly accept the market system and the value of advertising itself in that system. Their beliefs about what sorts of advertising are 'acceptable' closely reflect the interests of the most powerful corporate sponsors. In this case professional knowledge is tied to capitalism.
The military is basically a creature of the state, and hence the military profession is geared to the interests of the state. But since the state is not a unitary entity, the interests of the military can conflict with other groups in the state. Military knowledge is tied to both the separate interests of the military and to the wider interests of the state.
Doctors, lawyers, social workers and academics are primarily regulated by the state. Although many doctors and lawyers work for government bureaucracies - such as hospitals - a substantial fraction are self employed. Their degree of autonomy depends on the power of the profession in relation to the state. A strongly organised medical profession, such as in the United States, is able to minimise state regulation and maximise 'self-regulation'. When the state is stronger, professional autonomy is reduced, as happened with the introduction of state-controlled medical services in Britain. Whenever attempts are made by either group to seriously alter the balance of control, serious conflicts may erupt, as has occurred in Australia over payments to doctors working in public hospitals. In no case does substantial control over the profession by clients - patients - seriously arise as an issue.
Because the medical profession is relatively autonomous, professional knowledge is geared more to the interests of the profession itself. Medical knowledge tends to exclude forms of treatment which are not easily controlled by the profession, such as nutritional prevention and therapy.
Much more frequently than doctors or lawyers, academics are directly employed by the state. Struggles for professional autonomy thus proceed within the constraint of state financing of higher education. Academics are able to use their service to other powerful groups - capitalists and other professions in particular - to obtain relative autonomy within the constraint of direct financial dependence on the state. Because of this complex political configuration, academic knowledge is less tied to the interests of a particular group - including academics themselves - than is the case in most other professions. The selective usefulness of academic knowledge varies considerably from discipline to discipline. Within business and engineering courses, an orientation to capitalist values predominates, within law courses the interests of the legal profession are primary, while within subjects such as philosophy and fine art the interests of academics themselves usually come first.
The relative autonomy given to the academic profession in decentralised educational systems thus arises from the relative balance between several powerful groups which have interests in the use of academic knowledge: the state, capitalism and the professions. This is different from the idea that academia inherently requires intellectual independence. In practice scholarship can proceed in many different intellectual frameworks and political contexts. Many of them are very narrow and directive, such as military research programmes. Many academics are employed on research grants that very tightly specify their methods and goals. Other academics work in disciplines whose paradigms are reflections of interest groups, such as the managerial perspective in commerce courses. The key to understanding how academic knowledge develops is not the dichotomy between intellectual dependence or independence but rather the particular configuration of power. Three key influences are the state, capitalism and the professions. Also important, as discussed in earlier chapters, are patriarchy and internal hierarchy.
Professional knowledge can be used to tie together a professional group and a different powerful group. Knowledge in the area of nuclear physics and engineering illustrates this well.
Prior to World War II, nuclear research was mostly the concern of academic scientists. During the war, as is well known, the United States government in particular mobilised nuclear researchers to develop nuclear weapons. This marked the beginning of the massive involvement of the state in science and technology that has become commonplace in the decades since.
Knowledge about nuclear science and technology provided the avenue for the state and the nuclear research community to become dependent on each other. Because of the vital role that nuclear weapons play in state security, the state has funded, directed and supervised a great deal of nuclear research and development. This has meant that the professions of nuclear science and engineering have become heavily dependent on the state. But nuclear professionals are not powerless in this situation, precisely because they are in possession of expert knowledge on which the state is dependent.
The nuclear professions and the state support each other through the monopolisation of nuclear knowledge and the applications of that knowledge. Both groups are opposed to weakening their joint professional-state control over nuclear knowledge.
This was apparent in the case of 'the secret of the H-bomb'. A journalist, Howard Morland, spent a number of months piecing together the key mechanism which makes possible an effective fusion weapon (also called the thermonuclear, hydrogen or H-bomb). The information was actually available in open sources, but it never had been presented in a coherent form for a non-specialist audience in the context of a critique of state military policy. Morland did not write a do-it-yourself account of how to build an H-bomb: actually, his description showed why only major technological powers can construct one. His aim was to demystify nuclear policy making.
Morland's article was planned to be published in 1979 by the Progressive, a prominent left-wing magazine in the United States. For the first time in US history, the government put a prior restraining order on publication on the grounds of national security. Revealingly, many leading scientists supported the government's case, including scientists known as supporters of liberal causes. The planned publication of the Progressive article clearly was of enormous concern both to the US government and to many scientific elites.
This response can be understood in terms of the interests of both the government and the nuclear research community in preserving a monopoly on nuclear expertise. Morland's article did not reveal anything that was not available in the public domain. Indeed, the key insight about constructing the H-bomb had been published years earlier in an encyclopaedia article by a key insider in the nuclear establishment, Edward Teller.
What Morland's article threatened to do was to provide information to a public audience in the context of state nuclear policy. It was not the technical information per se which was important, but the technical knowledge in conjunction with the political context of its use. If outsiders could become informed about nuclear technology, then they would be in a much better position to analyse and criticise policies on nuclear issues. Restriction of nuclear knowledge to the nuclear research community and to the nuclear policy-making community - and, more importantly, sustaining the claim that these communities possessed exclusive knowledge essential to policy issues - meant that criticisms could be ignored or deflected as uninformed. Morland's article threatened the legitimacy of nuclear knowledge as a basis for political power. Because the article was to be published in the Progressive rather than in obscure technical journals, it threatened the mystique of nuclear policy-making.
A major court case over Morland's article ensued. Many prestigious scientists supported the government, whereas only a few experts testified for the Progressive. While the case was proceeding, a small student newspaper published Morland's article. After this the government dropped the case, and the article was published in the Progressive.
Reading Morland's article 'The secret of the H-bomb' in retrospect, and just looking at the information provided, it is hard to see what all the fuss was about. What was at stake was not a 'national secret' but rather the power of the complex of nuclear weapons researchers and the nuclear policy-makers in the state.
The relations between professions and the structures of the state and capitalism are constantly being challenged and renegotiated. One important long-term shift is the increase in the power of the state which is manifested in increased bureaucratic control over the affairs of professions. The responses of professions to this trend reveal their contradictory relationship with the state.
In the 1960s the tertiary education sector in Britain underwent a large expansion, an expansion identified with the Robbins Report which advocated and justified it. Many academics favoured the large increase in students, institutions and staff, and the associated increase in government funding for higher education. This is not too surprising. With more money and more positions available, academics already in the system had considerably increased opportunities for advancement. Also, there were obvious prospects for the increased influence of academics generally.
Therefore, it is perhaps surprising that a majority of British academics at the time had substantial reservations about the expansion. Part of this may be attributed to simple conservatism. But other factors are relevant. Expansion may provide opportunities for some academics, but it also poses threats. Stable power relationships and familiar routines come under attack. The expansion brings in its wake a more powerful bureaucracy to administer the larger finances and student numbers. Furthermore, if many more students obtain degrees, then the prestige of degrees themselves is devalued. Tertiary education becomes less exclusively the preserve of a social elite, and as a result the social prestige of academics may suffer.
Some academics, such as the empire builders, thrive in an expansion. Others, preferring the traditional power structures based more on social exclusiveness and collegial interactions, are less enthusiastic. The important message here is that professions are not always united internally. To the extent that they are not, they are vulnerable to control or manipulation by other powerful groups. This applies not only in the increased bureaucratic control over higher education, but also in the division of academia into different disciplines which can become linked to particular interest groups.
As control in the academic community has shifted from the profession itself to bureaucratic and managerial control, one response has been to form trade unions of academics. Here again there is a strong divergence of opinion within the academic community. Many academics adhere to the traditional image of the professional, upholding professional norms and expecting fair treatment as a natural consequence of community respect. But this attitude is at variance with the realities of bureaucratised politics, in which groups compete for social resources as power blocs. Without a voice in the bargaining system, academics lose out in terms of salaries and conditions. The increased support for academic trade unions is a response to this altered political scene, but one that strikes at the self-image of traditional academics.
Many professions have a great deal of power, and often this is used in ways that are not beneficial to the wider community, such as when the medical profession fosters curative approaches and downgrades social promotion of good health. There are a number of ways in which groups have responded to the problems generated by professional power.
Social responsibility. When social problems associated with particular professions become particularly acute and, more importantly, widely recognised outside the profession, groups of professionals may organise to promote 'social responsibility'. Essentially this is a response based on the usual professional goal of self-regulation, only in this case the regulation goes beyond internal affairs to encompass the wider social impacts associated with the profession.
In the late 1960s and early 1970s there was widespread social concern about the effects of science and technology. Such concern had first become a major issue with the development of nuclear weapons. The rise of environmental concern in the late 1960s combined with the social ferment at time led to some vocal attacks on science and technology and a decline in public support. One response was the setting up of groups of scientists and engineers who spoke out and took action on issues such as pollution and the military use of science and technology. Their basic orientation was that scientists and engineers, because of their moral concern, should put their own house in order.
The stance of 'social responsibility of professionals' is inherently unstable. It depends on a group of professionals being openly critical about the uses of professional knowledge, but at the same time restricting the challenge to reform of the profession stimulated by the social concern of the professionals themselves.
If the insider criticism of the profession is sustained and penetrating, it helps undercut the power of the profession itself. This is seen as 'going too far' by those reformist critics who are basically committed to the profession. On the other hand, a mild stance does not satisfy external critics and may easily degenerate into inaction. Once the social ferment that stimulated the social responsibility stance subsides, the remaining activists become open to attack from within the profession or to cooption up the career ladder. The social responsibility in science movements in the United States, Britain and Australia mostly dissolved by the mid to late 1970s. What remained or developed was a radical core.
Counter-experts and radical caucuses. Counter-experts are similar to professional experts, except that they support a stance that is critical of the dominant professional viewpoint. In the public debate about nuclear power, most of the nuclear research community supported nuclear power, and most of the public proponents of nuclear power were provided by the nuclear community. But a small number of nuclear scientists and engineers have publicly opposed nuclear power. In essence, these counter-experts have sided with the anti-nuclear movement or cause rather than with the source of political power most closely tied with professional interests, namely the nuclear power industry.
There have also been a number of counter-experts who come from outside the profession. Some of the most effective anti-nuclear power experts have been self-taught, such as economist Dan Ford of the Union of Concerned Scientists in the US.
A more collective form of counter-expertise is the radical caucus: a group of people in a profession who organise to develop alternative viewpoints. Radical caucuses of various types have developed in a range of academic disciplines. The discipline of political science in the US is in its conceptual frameworks and activities largely supportive of the prevailing political system. The Caucus for a New Political Science takes a much more leftist position. For example, it organises symposia at political science conventions in areas such as the relationship between the economic and cultural left.
Radical caucuses are essentially a way of tying a segment of a profession to a group - such as the working class - different from the group to which the mainstream of the profession is tied. As discussed in chapter 5, most professions are patriarchal, and with the resurgence of the feminist movement since the 1970s one of the most widespread radical caucuses has been women's caucuses.
The major limitation of counter-experts and radical caucuses is that they often remain tied to professional values. In many cases they remain committed to the importance of professional knowledge and expertise. The difference is that this knowledge is to be used to support a different group or stance. The ends are different, but the professional means are the same. This would not matter except that means often shape the ends.
Alternative masters. One way to overcome dominance by professionals is for the professionals to be dominated themselves. This is a continuing possibility in the struggles between professions and key structures including the state and capitalism.
When the 'alternative masters' solution is proposed, it naturally assumes that the new controllers serve the greater good. This perspective is especially prevalent in those sections of the left that look to the state to provide a solution to the problems of inequality and class domination. Just as nationalisation or state regulation is seen as overcoming capitalist exploitation in business and industry, so state control over professional services is advocated to curb professional exploitation. Conflicts between state bureaucracies and the medical profession are the most obvious manifestation of the struggle at this level.
There are several shortcomings to the alternative masters approach. First, state regulation may in fact turn out to serve rather than control the profession. The profession - or members of the professional elite at least - may take over the regulating body, which typically is part of the state bureaucracy. In many countries, elite academics hold powerful positions in state educational bureaucracies.
Second, the state, or any other 'alternative master', seldom resembles a neutral servant of the people. Professional dominance is simply traded in for dominance by some other vested interest.
Third, a takeover of a profession does not always lead to a weakening of the controlling function of professional knowledge. The mechanisms of professional dominance, rather than being dissolved, are turned to the service of the new masters. State-run medical services are not noted for any diminution of the monopolisation of medical knowledge. What happens in such cases is that professional knowledge, rather than mainly serving the separate interests of the professionals, is linked to the controlling or regulating body - not to the clients or the general public.
Deprofessionalisation. Doing away with professional services is the solution posed by Ivan Illich and others. Instead, there would be free access to information and skills. People could do things for themselves without relying on licensed experts, or they could consult experts without being dependent on them.
In the sphere of education, deprofessionalisation is called deschooling. People would study and do research as part of everyday life - in homes, in factories, in voluntary study groups - rather than via the ministrations of educational professionals.
What deprofessionalisation means in practice has always been rather vague. If professional monopolies - compulsory schooling, medical monopolies, high-speed transport systems - were abolished in present society without other changes, what would happen is a shift in power from professions to the state and capital. A strategy to achieve deprofessionalisation without this consequence - in other words, to reduce the power of professions while at the same time challenging state power, capitalism, patriarchy, etc. - has not really been spelled out.
Randall Collins, The credential society: an historical sociology of education and stratification (New York: Academic Press, 1979). The politics of organisations, culture, education, professions and the sinecure society.
Charles Derber, William A. Schwartz and Yale Magrass, Power in the highest degree: professionals and the rise of a new mandarin order (New York: Oxford University Press, 1990). On professionals as a powerful interest group.
Ronald Dore, The diploma disease: education, qualification and development (London: Allen and Unwin, 1976). An illuminating treatment of the explosion of formal education in poor countries due to the role of credentials in allowing entry into modern sector jobs.
Eliot Freidson, Professional dominance: the social structure of medical care (New York: Atherton, 1970). A clear exposition of the use of professional knowledge and skills to dominate clients and other professionals.
Ivan Illich et al., Disabling professions (London: Marion Boyars, 1977). Essays on how professions turn people into consumers dependent on professional treatments.
Terence J. Johnson, Professions and Power (London: Macmillan, 1972). An abstract critical account of conventional analyses of professions.
Magali Sarfatti Larson, The rise of professionalism: a sociological analysis (Berkeley: University of California Press, 1977). An abstract penetrating analysis of the development and dynamics of professions.
Edwin T. Layton, Jr., The revolt of the engineers: social responsibility and the American engineering profession (Cleveland: Case Western Reserve University Press, 1971). The dynamics of the engineering profession and US capitalism.
Jethro K. Lieberman, The tyranny of the experts: how professionals are closing the open society (New York: Walker and Company, 1970). An example-filled account of how professional groups use legal and institutional means to protect their vested interests, described within a liberal critique of democratic pluralist society.
Frank Parkin, Marxism and class theory: a bourgeois critique (London: Tavistock, 1979), chapters 4 to 6. Material on social closure as an alternative to class-based approaches.
On the attitudes of British academics to tertiary expansion in the 1960s see Gareth Williams, Tessa Blackstone and David Metcalf, The academic labour market: economic and social aspects of a profession (Amsterdam: Elsevier, 1974).
On the de facto black list of nonstandard cancer therapies, see Ralph W. Moss, The cancer syndrome (New York: Grove Press, 1980).
On the Progressive case see the Progressive itself from 1979 onwards, and Howard Morland, The secret that exploded (New York: Random House, 1981).
On the Caucus for a New Political Science, see the journal New political science.