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How does a short history of professions help us think about professionalisation today?
14th Australia Studies Conference in China
Mudanjiang Normal University, 11-14 July 2014
Department of Sociology & Anthropology
La Trobe University, Australia
Abstract: Modern western professions emerged from pre-modern European society. They
were built on traditional functions such as healing, education, law, engineering, finance and
other fields. But they are quite different from those ancient skills in many respects.
Professions stand at the crossroads of practical implementation, often at a very large scale,
of modern systems in each of these fields, applying science and technologies that require
abstract knowledge and understanding of general principles. In modern society educated
professions and professionals are now taken for granted as providing necessary skills. This
paper takes a historical perspective, sketching pressures and opportunities in four half
century segments across the 19th and 20th centuries in modern professional development.
The paper briefly outlines some of the debates and developments in this creative response
to the demands of modernising society. This invites consideration of changes in professional
work today and in the future.
Today I would like to bring my interest in professions and professionalism to the conference
theme of Creativity and Development as an opportunity to see in a range of occupational
innovations how we might create liveable futures for our societies. There are many ways
this subject can be opened up: in this discussion of the western experience of professional
development I propose a simplified half-century by half-century historical sketch of
professions, noticing thereby some of the social and economic factors that have influenced
how these professions have developed. By bringing these alternative possibilities to
consciousness, instead of treating them as a kind of “natural” or inevitable modernisation
sequence, they thereby serve as tools for current thinking about what kind of professions
and professional workers and forms of expertise are useful to society today.
Let me, as part of introducing this method of unfolding an over-generalised and selective
account of the sociology of professions and professionalism, by apologising in advance for
treating history in such a cavalier manner: as though history can be constrained into half-
century chunks! And events do not tidily stop and start on the century roll-over, either. I am
not going to, even in self-defence, get myself involved discussing issues affecting all
historical study that involve selection, abstraction and periodization. Rather, for my purpose
of illustrating from the existing portfolio how different countries have “done” professions,
the approximation made here will provide the necessary platform—partly pointing to what
has happened with professional expertise and occupations, on some version, and partly
pointing to what creative innovations in this area might be in the present, and into the
future as well.
In a similar way that digital technology is often felt to be cutting edge in social and economic
change today, with numerous creative possibilities for the betterment of society, new
modes of scientific knowledge and techniques were aroused in the late eighteenth and
nearly nineteenth centuries in Europe. Over two centuries these innovations ramified into a
complex division of professional labour (Abbott, 1988).
Short history of western professions
Government efforts such as the 19-19th century string of European veterinary schools, and
societies for the advancement of knowledge in diverse fields of human endeavour emerged.
One example of the latter I am familiar with is the Odiham Agricultural Society established
in 1770s promoting farm and animal innovative practices and agricultural improvement; the
Society played a role in the development of modern veterinary medicine (Pugh, 1962).
Ancient forms of professional expertise in law, religion or medicine are invoked as narrative
of worth and foundation myths, but in fact modern profession are of recent provenance:
the last two centuries, coeval with what historians and sociologist currently call the modern
The political and decisional processes of creating, configuring and reconfiguring professions.
It is important to have a comfortable clarity about the possibilities here, because we are on
the cusp of a huge change in professional capacities in many areas—technology,
miniaturisation, robotics, genomics, cancer and more. The interpellation of legal systems
and accreditation systems and the outsourcing of professional-level work—no longer
restricted to factory or commodity level production—is happening apace. So we need these
lessons from the historical record. Even more than the lessons we need more familiarity
with the evidence produced collectively over a couple of centuries inventing professions
almost from nowhere.
Furthermore, that these workplace creations and innovations are multiple and varied: there
are many professions today, way beyond the few elite professions that formed the template
or model upon which the present movement to professionalisation has and is occurring.
Contemporary education systems interact with the production of professions. When India
says it has too many uneconomic or substandard medical school and pulls the licences on
nearly a third of its present intake, the screams of fury that families and would-be doctors
utter is understandable but should not be the determining view that cooler heads thinking
of the nation’s best interests as a whole are grappling with.
My purpose, then, is not trying to be historically complete, but rather the opposite, to
identify issues that are present and important in the evolution of professions in the modern
era as it historically happened. These include events and data that often do not appear in
the formal descriptions and profiles supposedly explaining professions in English speaking
countries. Current and future professional developments are not simply based on the
template, the same as previous professionalisation projects. They take place within the
world of professional work and the expert division of labour produced and now extant from
that template. Effects of this difference may include resistance to, acceleration of, or
variation because of the now-existing professional powers, relationships and changed
labour market expectations.
First half of the nineteenth century
The first half of the nineteenth century witnessed an amazing occupational orogeny—a term
geologists use, but apt for our purposes today given the importance of professions and
professionalism around the world—referring to professions’ moment/era of creation in a
modern sense. But early-modern professions were very different in terms of governance
and identity than what is commonly conceived of as professions or professional today.
Government patronage and social class were fundamental components in establishing these
first versions of contemporary professions. Millerson (1964) describes the half-century
process of setting up a series of Royal Colleges in England under a system of protective
patronage and formalisation of expertise of occupational groups, shifting from guilds who
controlled ancient learning and texts, to groups who were, in principle at least, starting to
engage the new ideas of science and empirical investigation. These groups represented the
elite of society, and were dismissive of more rural/regional and less refined parts of society.
Amalgamation of medical groups—apothecaries, surgeons, and physicians—over time lead
to the beginnings of modern medicine. Dozens of Royal Societies were formed in the first
half of the nineteenth century.
For example, according to Reader (1966, pp. 163-164):
the first of the new professional associations was the Royal College of Surgeons
chartered in 1800. The Apothecaries got their act with its formidable disciplinary
powers in 1815. In 1818 the Institute of Civil Engineers was set up; in 1828 it was
chartered. The Institute of British Architecture, founded in 1835 was chartered in
1837, and entered on a long period of quarrelling with the other architectural
foundations, which delayed the granting of statutory privileges in 1931. The Law
Society founded in 1825 was chartered in 1831, but the charter was surrendered for
a new one later on. In 1844 the Pharmaceutical Society was chartered, and in 1844
also the Royal College of Veterinary Surgeons was chartered.
Although not an exhaustive list, as Millerson (1964) notes, this was a wave of professional
organisation establishing professional occupations in a distinctly modern way, yet bridging
from pre-modern local patronage models. This key to understanding professional
development in this period was picked up by Johnson (1972) in his typology of professional
forms. The presence of this variety of forms complicates any simple assertion or description
of professions and professionalism. The discussion will come back to Johnson’s types in
considering the fourth stage in the second half of the twentieth century.
Without going into the many complexities of early north American modernity experience at
this time—European professions were more distinctly seen as part of the apparatus of
government (a characteristic that inflects their function and control right through to the
present day)—a key aspect that informs this discussion about how profession are created
and are creative, is the cultural response in the period of Jacksonian America, 1830s-50s
(Wilentz, 2005). Issues of monopoly of government by social class elites and the monopoly
of service delivery, combined with an anti-education milieu, and doubts of scientific efficacy
delayed prioritizing scientific standards rather than superstition. The language of “quackery”
and “health nostrums” versus scientific solutions, made by professions to demarcate their
claimed occupational territory being contested dates from this time.
Second half of the nineteenth century
This period passes from elite professional entrepreneurship of royal patronage or urban
elites relying on patrons for exclusion, to models of professionalism expanding to include
intelligence rather than just social standing. In fact, a fusion of bright younger sons of well-
today members of society often sought out the slightly “cutting edge” experience of
professional and/or scientific work, not just in narrowly defined professions, but in
geographical exploration and scientific inquiry in the western colonial era. Social class
standing was nevertheless a core component in the traits ascribed to professionals, and key
in the delivery of docterly, lawyerly, or clerical exercise of authority in gaining client
Millerson (1964) identified four kinds of professional association in his analysis of intra-
professional groups, and this period saw the emergence of alternative corporate
structures—often competing with one another on the same or adjacent occupational
clusters. For the present discussion this is significant in yet again pointing to the contingent
nature of modern professional evolution. Even if for a moment one removes focus on
governance questions of patronage, or regulatory environments, provided by the state in
managing professions, these variations in what segments of individual professions strove to
achieve, or saw as their mission, gives the lie to autochthonous professionalism, or
professions as phenomena ding an sich, in and of themselves.1
The adaptability and divergence evident in this period in the professional corporate sense of
what Larson (1977) calls professions’ twin goals of a market project and a status project,
potentially undermine any simple, coherent, recognisable set of occupational institutions
called professions. Yet in this period middle-class—male-gendered (Witz, 1992)—projects
did in fact emerge and were increasingly crystallised for elite groups. How such groups were
created, defended, contested internally with other professions, cultural and political orders,
and morphed though alliances, regulations and economic drivers, all impacted the further
development of organisational structures and powers of professions. Parenthetically, the
salience of urban-rural divides in professional functions and positioning in earning, moral
worth, expectations of progress, and application of science, is important.
The four analytic distinctions Millerson (1964) observed within the corporate structure of
these occupations shows the contested multifarious nature of professions and
professionalism, even as professions developed over time: the “qualifying association”, the
“occupational association”, the “prestige association” and the “study association”). Which
of these groups held power and influence depended on many contextual matters such as
the nature of their work, metropolitan or colonial location, political or class importance of
1 There is yet another layer of ambivalence not explored here in tracing the differences between speaking of professions collectively and
analysing individual professional projects.
the profession, and where it fitted in terms of Johnson’s (1972) typology. Each factor
interacted with previously negotiated positions and expectations with other professions and
Even in this activity and creative and developmental energy, the dystopian elements that
Jacksonian America had seen in professional closure, continued to be highly contested.
Professions’ measure of success lay in increasingly monopolising specific domains of
expertise under the twin legitimations of (1) scientific expertise, and (2) altruism and moral
worth. The complexities of such normative orders, though hard to summarise, can be seen
in Bernard Shaw’s (1906) famous epithet that professions are conspiracies against the laity,
echoing Adam Smith’s (1778, p. 145) words one hundred-plus years earlier about people in
the same trade acting as a “conspiracy against the public, or some contrivance to raise
First half of the twentieth century
The energised, “good,” doctor or other professional at the start of this period constituted an
heroic template that established a pattern for the following decades. The half-century is
characterised by the use of this template ideologically bracketing the regulatory
environment in which professions existed, and asserting both personal and corporate
individualistic ideals about professional work in the United States setting. Though less true
of European or other national contexts, this template became the aspirational model of
many western countries. Professionals employed in the public sector, mostly government
service, and the growing social class possibilities of rising professional incomes were less
visible parts of this transformation of professional work in the new century.
The half-century moves from the heroic or pioneering professional to the charismatically
successful career; think: little black bag of medicines and home visits. Flexner (1915)
undertook a survey of medical schools and recommended that government close some and
restrict others—not unlike the realignment happening to Australian and Chinese higher
educational institutions today, even if painful for individuals or individual institutions. Such
government involvement with the skilled labour supply sits athwart the assertions of self-
running independence of western style university institutions, leaving them open to charges
of self-interest, or more neutrally, sub-optimising national needs and other considerations.
An early example of chronicling and attempting to theorise professions can be seen in Carr-
Saunders and Wilson (1933). This structural explanation assumed a unitary, linear, natural
modernisation pathway for professions. These assumptions became more constraining in
mid-century structural–functional accounts of professions that ignored the macro-economic
and macro-social contexts that created them and within which professions served (Goode,
1957). Even private funding of training skills and providing work still begged the question of
fit with overall society need in different sectors, as well as technological and delivery
developments taking place.
The rhetoric of American professional autonomy was largely presumed as self-evident in the
altruistic ideal of professionalisation, notwithstanding other active forms. This was fuelled
by academic analyses like Becker’s (1961) Boy’s in White about medical training. One
counter-narrative to the mid-century American Dr Kildare medical television series’
charismatic doctors and successful narrative was the public professional, or the small-town
professional, serving the public good in various, not necessarily high-profile or flashy, ways.
Practical problems around widespread professionalisation—“The professionalisation of
everyone?” (Wilensky 1964)—crossed with theoretical problems about unhistorical views of
professions, but were not resolved by commentators such as Vollmer and Mills (1966).
Other national stories of professional development were very different from this dominant
western narrative, for example Mexico (Lorey, 1992).
Second half of the twentieth century
I call this final half-century period in our present sketch the period of “post-professionalism”
(Burns, 2007), but this only refers to theorising of professions and professionalism. Most
commentators have struggled to find an acceptable term (Macdonald, 1995). In the actual
workforce of occupational change and development in professional or white-collar work in
this period, the variety of occupations and the number of individuals classified by
government censuses as professionals or “technical and professional”, or even managerial
and professional, exploded.2 A concomitant change has been the enormous expansion of
tertiary education (there is a chicken and egg thematic here) in western economies,
something now happening across Asian countries in the now emerging half-century at the
end of this quick historical overview.
Historian Perkin (1996) interprets this period as a splitting of the generic assumption that
phrases such as “the professional classes” were undifferentiated, by proposing that the
government service classes were established in this period as clearly different from career
pathways using the same professional skills and training but applied to creating large
amounts of income and high status. He asks via considering global examples whether
professional corruption is more damaging than monopoly. Even more “blue-sky” and
contentious is Perkin’s (1996) thesis that the rise of profession represents the third great
human societal evolutionary step after humanity’s shift from hunter-gathering to farming,
and the industrial revolution.
Illich (1975, 1977) a political theologian wrote excoriating analyses of mid-century United
States professions, medicine, education and others, charging them with servicing self-
interest rather than the needs of trusting clientele groups. Such re-moralising and
problematising the normative assumptions of professional “goodness” and self-affirmations
of altruism, community service and other-directedness as core traits, extended academic
critique of functionalist sociology. At the other end of this period, Harford (2007, p. 24)
repeats Adam Smith’s and Bernard Shaw’s concerns of previous eras about the
conspiratorial effects of professional monopoly, speaking as an economist.
For sociologists this period is sharply demarcated from the previous one by the writings of
Freidson (1970) and Johnson (1972) either side of the Atlantic. Freidson demonstrated that
the one size fits all templates of professions was not possible (Goode, 1969), and was not
how it had happened. Contra Pavalko’s (1971) reiteration of trait theory, professions
2 There is another fascinating story in the discursive shifts in application of “professional” to diverse people and settings though these recent
decades; some might suggest a discursive commodification.
asserting their autonomy from control by other groups, interest and organisation were re-
framed as phenomena under scrutiny not the arbiters of their own legitimacy. Even if
partially true at mid-century, the second half of the twentieth century evidences a unitary
view of professions was becoming much less true.
Professionals work in distinct sectors or fields, often in hierarchical divisions of labour.
Claims to autonomy often appeared as “spin” to deflect attention from the actual level of
performance of practitioners. Johnson’s analysis, grounded in historical and comparative
investigations, showed much greater diversity in the modern development of professions.
Johnson’s analytic typology could be said to be an abstract framework, but like others of his
era, it protested the constraining ideology of United States’ autonomous idealisation of
professions collegial professionalism, identifying in the mix other forms: professional
patronage, mediated professionalism, and professional heteronomy.
In western societies this post-professional era was first concerned with the redistribution of
power between professionals and clients. Steadily it widened out to issues of professional
performance or quality measures—health, law, education is not just an endlessly absorbable
cost, and pressure has begun to turn on professionals to justify their high charges. The
quality of Cuban medical profession in this half-century is an intriguing counter-example of
industrialised, institutionalised, pharmaceuticalised, privatised, very costly medicine.
Counter-factual arguments or historical instances are always good to reason with about
what can and should be attempted.
With the advent of many more practitioners of any given profession other questions have
continued to arise. The quality of professional performance, in medicine in particular,
moved from self-evidently perfect or what it should be (“doctor knows best”), via Illich’s
description of iatrogenic medicine and poor patient outcomes, to a sustained and ongoing
challenge by Leape and others to shifting the complacency and doctor-centric service
delivery model to more adequate performance levels (e.g. Leape, Berwick and Bates (2002).
Health insurers and government health deliverers have also pushed in this direction. The
issue of professional quality has become a major issue in most, but not all, professions, and
attempts to address it via risk, performance, error rates, quality, audit and other mechanism
have been varied in their degrees of success.
Martin (1998) describes the growth of corporate managers and professionals as the
twentieth century’s two success stories for the middle classes in western societies. A
number of current changes place question marks about this, but in terms of status, working
conditions, intrinsic work interest, and earning capacity, this has indeed been a remarkable
continuing upward trajectory across these two half centuries. The western and Amero-
centric hegemony over this period has led to a belief that there is one main way to “do”
modernity and modernisation, something increasingly disputed by historical and sociological
scholars. Johnson’s (1973) analysis of British Commonwealth countries showed major
differences even with the organising effects of metropolitan-imperial relationships. Success
may be achieved in other ways than this western template.
A point I raise (Burns, 2007) in my post-professional model is the self-evident nature of ever-
greater enfolding of professions into, within or adjacent to, corporate embrace. Though
some professions, like engineers, have always operated mostly in this way, the mythology of
mid-twentieth century professions is of independent, high-flying, wealth creators. However,
is not true of non-metropolitan professionals; stories of average national lawyer earnings, to
take just one example, are on the contrary, quite low in Australia and other jurisdictions.
Contradictions of ideas that professional are autonomous, exercise independent ethical
judgement, are motivated by the intrinsic nature of the professional-technical issues before
them, abound in this late-modern environment.
Research continues to expand in western contexts about professions and professionalism
(Macdonald, 1996; Halford and Leonard, 1999). This paper has not explored the rich
discursive issue within professionalism—important in itself as a vehicle for analysis.
Unfortunately for a more global understanding even scholars such as Freidson got stuck in a
United States-centric view of further professional development (e.g. 1994, 2001) even as a
multiple-modernities model has been gathering momentum.
History of professions: four half centuries—then to now
Each of these half-century periods highlights for us important choices or constellations of
negotiated positions and modes of governance that resulted from the players, the resources
they had and the reactions of other significant groups, and the needs driving high-minded
people to resolve in most sectors of society and increasingly modern living. Like many
socially important phenomena, professions are mythologised both by their members
seeking legitimation and by outsiders.
Historical insight is a great teacher for the present, and this last section of the paper draws
out some of these insights for creatively developing and adapting profession to the very
new world we are facing in this new century.
Johnson provides us with a first tool for thinking about professions (Burns, 2013, p. 11) as
producing or delivering professional services; these are his four types:
first, where the producer has all or most influence in defining the producer–
consumer relationship; second, where the consumer has all or most influence in
defining the producer–consumer relationship; and third, where an intervening party
mediates the producer–consumer relationship, imposing its definition of the
situation onto the interaction. An example of the first is in optometry; an example of
the second is engineering; and an example of the third is social work where
government mediates supply and consumption of social work services. A fourth type,
heteronomy, another intermediate form of control, was later identified (Johnson,
1980) where the two parties, producers and consumers, more evenly contest the
definition of the relationship.
Second, Sharma (2014) takes Johnson’s broad principles and applies them to contemporary
China’s situation of rapid growth across a very large society and the need, on economic,
social and education grounds, to better match inputs and outputs when viewed at the larger
In a bid to reduce the huge number of university graduates with similar academic
degrees competing with each other for the same jobs, China has announced that it
will turn at least half of its public universities into institutions of applied learning or
polytechnics to produce more technically trained graduates. The radical, wide-
ranging move will transform the country’s higher education landscape, education
experts said. Lu Xin, a vice-minister in China’s Ministry of Education, announced the
decision to turn 600 of the country’s general universities into polytechnics at a
meeting of college and university leaders at the 2014 China Development Forum
earlier this year.
The idea of modelling the German experience of a dual system, called fachcochschulen, but
allowing movement between the two to better suit capabilities of individuals but
importantly to address the needs of society as a whole. Done explicitly on the grounds of
market relevance or irrelevance, we might consider the active presence of alternate
professional models to profit-driven models or institutional defensive monopolies.
The switch to more technical and vocational higher education ‘has a lot to do with
the relevance of higher education. Rapid growth in universities caused many
programmes that were not very relevant’ to be offered, Qiang told University World
News, adding that the polytechnics would help reduce the unemployment rate
among university graduates.
An interesting connection in new developing large societies such as China dealing with the
explosion of tertiary education is the emergence of cross-over connections in the
development of professional and technical skills. This globalisation process can be seen in an
earlier decade when a quarter of the United States physics and mathematics PhDs were
from China. A current example this year can be seen in the Indian government's decision to
restrict by about a third the number of entrants to medical degrees in that country. But not
only this, the development of “China as a preferred destination for medical education”
(Mishra 2012) is a change from previous expectations. Some 8,000 Indian students enrolled
in Chinese universities in 2010—some seven out of ten Indian citizens studying outside
Professionals often avoid talk of themselves as constituting a labour market, or offer over-
weening accounts of restriction for elevating professional quality. Yet economists need a
greater voice here, not just that of university departmental estimations how many medical
doctors, veterinarians, English teachers and so forth are needed, but a more sophisticated,
big data backed analysis for identifying professional occupational trends, relating that to
credentialed outputs for universities and other tertiary providers, and matching that with
projected demands. Machin and McNally (2007, p. 2) aim:
to examine how the organisation, financing and management of tertiary education
can help countries achieve their economic and social objectives. The focus of the
review is primarily upon national policies for tertiary education systems, rather than
upon policies and practices at the institutional level. However the management of
tertiary education institutions will be relevant to the extent that policies to improve
institutional management can help to progress national policies.
Of course this is being done in many places, but in a fickle changing world the pre-big-data
era has been a relatively crude process in Australia and elsewhere. China’s own difficulties in
now having a significant cohort of graduate unemployment signals the need for changes
that are more than just adjustments round the edges—wasted human capital and frustrated
career pathways, and unbalanced national needs remaining unmet (Zhang and Adamson,
2011). The government’s current response to the present circumstances is appropriately at
the macro level in addressing the cross-pressures in the sector producing professionals
(Sharma, 2014). Abbott and Smith (1984) considered the importance of labour-markets for
professional work, bringing concepts across from more commoditised sections of economic
theory; yet it has taken the Obamacare debates to bring to the surface clear and well-
articulated arguments and processes demonstrating the benefits of co-ordinated, whole-of
society approaches to health. This raises, too, implications for other areas of professional
Each of these periods is instructive in demonstrating the variety of organisational principles,
resources and power relations that have been instrumental in forming the configuration of
professional expert knowledge as it is constructed today. As Australia and China continue to
change over the next decades the efforts to create desirable outcomes for citizens and
client groups will be huge and attract increasing attention (Alford, Kirby, and Winston,
2010). Equally, by that same process, the evidence here is that there is no fixed model or
formula other than scientific knowledge, rules of governance relative to market forces, and
A number of themes seen in historical rear-view are actively at play: professional
regulation—China and New Zealand are one-state systems compared to Australia and New
Zealand; establishing and maintaining professional quality through audit procedures and
ongoing professional training; the application of big data to matching, measuring and
moving skill performance and professional service delivery; creating legal mechanisms of
redress for poor professional service delivery via trade and consumer protection. Evidence
of the apparent universal truths of science and professionalism are highly contextualised
nationally and culturally in just how professional services are created, paid for, distributed
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