Editorial for Journal of Operations Management special issue on “Professional Service Operations Management (PSOM)”

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Editorial for Journal of Operations Management Special Issue on
“Professional Service Operations Management (PSOM)”
FINAL PRE-PROOF VERSION
Jean Harvey, University of Quebec in Montreal, Canada.
Janelle Heineke, Boston University School of Management, USA.
Michael Lewis, University of Bath School of Management, UK.
1. Introduction
Professional services such as medicine, law, dentistry and education clearly
sit at the centre of our societies but, perhaps less obviously, knowledge-
intensive services of various kinds also make increasingly important economic
and employment contributions as economies develop. These services,
including management consulting, investment banking, advertising, engineering,
architecture, etc., also provide critical inputs for other public and private
sector organizations as they seek to create high value products and services.
Yet despite this societal and economic significance, perhaps in part because
of their typically ‘supporting’ role, professional services remain largely under-
researched in the Operations Management field. This special issue represents
the multi-year cumulative efforts of a group of scholars who responded to
our call to attempt to better characterize this “distinct environment for
managing operations” (Goodale et al., 2008, p. 670). Their work is varied in
approach and focus, ranging from analyses of ‘classic’ professional service
settings, such as healthcare operations, to investigations of other advisory
services, such as global engineering networks, to explorations of how bodies
of professional knowledge emerge and the dynamics of how value is
appropriated by boundary keepers, knowledge workers, and clients. Taken
together we believe these papers better detail the shape of what we are
convinced remains a significant opportunity for OM scholars to undertake
novel, interesting and, critically, impactful research. In this editorial, we try to

locate the various papers in a broader conceptual framework, including some
specific additional insights where appropriate and signposting some areas
where we feel the SI has limited coverage.
2. So, what are Professional Services?
From an operations management perspective professional services are
typically understood using two principal dimensions:
1. Levels of customer contact (i.e., lots of face to face interactions,
meetings, consultations, etc.) and consequent delivery specifications
(i.e., every condition, case, problem is different) are understood to be
high, and;
2. Operational processes that emerge as a consequence of ‘professionals’
making judgments about both ends (what constitutes an
adequate/appropriate outcome) and means (the content and sequence
of process steps) are essentially fluid/flexible in character.
Interesting - and broadly valid - though such service characterizations can
be, they leave scope for substantial further reflection/investigation. Figure 1
builds on insights from Abbott’s seminal sociological analysis of professions
(1988), to model this process of professional judgment.
Figure 1. The Process of Knowledge Work (adapted from Abbott 1998)
! !
Body of
Knowledge
Client(s)
!
inference
diagnosis
treatment
!
Professional
boundary

In both the diagnosis and treatment phases (N.B. the language is medical in
origin but equally applicable to other professional settings, such as law)
information is taken from/about the client into the professionals’ knowledge
system – itself typically acquired via extended, multi-year, specialized training
in a body of, often abstract, knowledge - and “instructions” are brought out.
It is important to highlight (cf. Lewis and Brown 2013) that in many cases
this diagnosis/treatment process can be almost automatic, connecting a
series of essentially standardised inputs and outcomes but in those
circumstances “when the connection between diagnosis and treatment is
obscure” (Abbot 1988: 49), the professional will engage in a process of
inference. This is where reflection and creativity is applied and inputs,
process and outputs are subject to significant uncertainty and decisions
regarding all three are potentially risk bearing. Of course this interaction
between abstract knowledge and “real” problems also endows professional
groups with significant strategic flexibility because, as Abbott (1988: 9)
suggests: “only a knowledge system governed by abstraction can redefine its
problems and tasks, defend them from interlopers and seize new problems.”
Although these ‘abstraction-inference’ characteristics apply to most
knowledge-intensive services, what defines some of these groupings as
explicitly professional is that the body of knowledge they train with, and
subsequently draw on when making judgments is externally (but normally
non-governmentally) regulated and controlled in its content and application
(von Nordenflycht, 2010). These professional boundaries create what is, in
effect, a series of knowledge monopolies that act to exclude others (for
example, you cannot practice law in a country unless you achieve credentials
within that country legal system) and ensure high relative labor costs (Verma,
2000, p. 14).!!They are also central in the maintenance of standards. For
example, professional bodies typically maintain explicit codes of ethics and
shape implicit norms that guide appropriate professional behavior. The
American Bar Association, for instance, articulates the “core values of the

legal profession’ to include undivided client loyalty. In other words because
professionals should privilege client interests (Caveat Venditor) above their
own, clients can trust the quality of their judgment work despite the opaque
nature of the judgment process, based on asymmetric knowledge, and often
ambiguous outcomes. Interestingly, the question of professional standards,
where they come from, and the extent to which a formal professional body
is necessary for their maintenance is itself a dynamic, often strategic, choice.
McKenna (2006) for example, in his history of management consultancy,
notes how McKinsey and Co. managing director Marvin Bower strongly
emphasized the voluntary adoption of professional norms more commonly
associated with law firms as a key part of setting his firm apart from its
rivals.!
Managing Professional Services
So far the definitional discussion has centered on the professional service
exchange itself, typically embodied in advisor-client dyads, and the
relationship with a meta-level body of knowledge (regulated or not). These
characteristics, autonomous judgment and external regulation/accreditation,
also create a significant practical challenge for any notion of management or
co-ordination in a professional service setting (cf. Harvey 1990).
An illustration of these governance dilemmas can be framed in triadic terms.
Consider how initial power afforded to the firm (Fig. 2a) is significantly
diminished after initiating client-employee engagement. It is now individual
professional employees that build ties with clients (Fig. 2b); building
independent relationships that can potentially be the basis for
disintermediation (i.e., individual employees regularly take their clients with
them as they move to new firms, set up their own, etc.).

Figure 2 (a) Firm as initiating professional-client bridge; 2(b) Bridge decay as
relationship between client and professional(s) develops.
Bridge decay is neither universal nor inevitable; if the firm controls specific IP
(e.g., the IDEO design method) or certifications and/or those reputation
(perhaps supported by a large marketing spend) is important – then the firm
can maintain significant control. Because important problems are involved
and a professional knowledge gap exists, the strong bond hinges on who the
customer trusts. In some sectors, these dilemmas are offered as an
explanation for the persistence of the partnership model but partnerships are
not prevalent or even possible in all professional services setting (e.g., there
are more accountants and engineers working outside PSOs than inside; many
European doctors are government employees, most social workers work for
government agencies, etc.). While their work is no less professional, questions
about their management and control depends on a host of different
variables. That said there is evidence that in a non-partnership setting,
professionals are able to resist traditional normative interventions (such as
knowledge management initiatives).
3. What is Professional Service Operations Management?
Given that OM is primarily concerned with the operation/organization as a
unit of analysis, what about the questions that pre-occupy OM: processes,
Management(of(
KIP(Firm(
Firm’s((
Client(
Professional((
Employee(
Management(of(
KIP(Firm(
Firm’s(
(
Client
(
Professional(
Employee
(

performance, scale economies and capacity, technology, quality, continuous
improvement, supply chains, etc.?
We have already explained that the extant PSOM literature is under-
developed but drawing together our analyses with insights from the papers in
the SI, we can provide an overview of areas that can inform the current
state of the art in PSOM and help identify areas for further exploration.
Processes
It is (somewhat ironically) accepted - and widely taught – that professional
services are characterized by their extensive process customization,
complexity and throughput variability. In the special issue, Brandon-Jones et
al. challenge this simplifying assumption with the results of their ‘deep dive’
into consultancy in the US travel, tourism, and hospitality sector. They note,
for instance, that rather than being highly engaged with their clients,
consultancy can be actually quite remote and passive and that face-to-face
engagement is typically time-limited and focused on specific project phases.
Moreover, this distance is often at the behest of the client. They also
observed significant contingent variation in the operational characteristics of
their sample. For example, the relative degree of client-consultant interaction
appeared dependent upon degree of expertise; with super-specialists spending
less time with clients and only the more generalist firms (complementing their
limited expert status) engaged with high levels of interaction (networking,
etc.). The well-documented use of leveraged work management where ‘simpler’
work is devolved to lower cost (e.g., junior lawyers) and/or differently (less)
qualified (e.g., paralegal) employees – also contradicts the simplistic notion of
all professional work as complex. Lewis and Brown (2012) used case-based
observation to conclude that archetype ‘judgment’ work will be made up
much less of the total activity mix than might have been expected, with a
classic portfolio of grey matter, grey hair and procedural work evident.
The presence of significant amounts of standard work inside the professional
service space suggests an opportunity for PSOM in terms of classic process

improvement interventions. In the SI for example, Dobrzykowski et al. used
hospital survey data from 211 US acute care hospitals to look at the
adoption of Lean techniques in a healthcare setting they discovered that a
lean orientation permitted providers to both focus on individual patient needs
and standardize care delivery procedures. Interestingly however, the
conditions that will finally precipitate this division of labour remain unclear.
Richard Susskind, for example, celebrated legal futurist, has long argued that
technology will accelerate the process of decomposition of (some)
professional work into its component processes and yet, to date, the
adoption of process management and other technological solutions remains
at best partial. Perhaps informal questions of trust, formal barriers to entry
(and the political lobbying power of many professions) still favor traditional
models of service delivery? Consider the online legal services provider,
Rocket Lawyer, offering a range of standard on-line legal services
(incorporation, wills, etc.) plus connection to a network of ‘real’ lawyers.
Founded in 2008, it has received $45 million in funding, claims 30 million
users and yet today only generates $20 million in revenues. The 2014
balance sheet for the UK operation shows that Rocket Lawyer UK’s total
liabilities exceeded its total assets by £2.88m (up from £1.98m in 2013) with
the accounts said the company ‘relies on the ongoing support’ of its parent
company. It seems likely firms like Rocket Lawyer and LegalZoom will become
fascinating PSOM exemplars but also that, at least initially, more likely be in
expanding into underserved markets rather than in displacing existing legal
services.
In the SI, Lawrence et al. extend our understanding of the dynamics of
process change, the tension between innovation and commodification, with
professional standards playing an integral role, by presenting a longitudinal
study of the evolution of a specific professional service – Leadership in
Energy & Environmental Design (LEED) consulting. They propose a life-cycle
model to better capture the dynamics of the knowledge base (embodied in
practice and the body of knowledge), number of professionals and client

markets, together with changes in the broader stakeholder community and
adjacent market and technological forces evolving. Professional standards
define appropriate practices, but structuring the work environment so that
those standards are followed not only helps the professional to do his or
her work, but also assures quality and, because work is more efficient and
rework is less often required, reduces costs. It has significant theoretical
implications for the essentially static, cross-sectional view of all services but
more practically, suggests that professional firms can co-ordinate efforts
(both hierarchically and temporally) to proactively manage transitions along
the evolutionary path. Standardization and specialization in their case
improved talent allocation and boosted future innovation.
Scale, Technology and Investment
When compared with large-scale manufacturing (and many service)
operations, professional services in general exhibit relatively low capital
intensity but there are still, often very significant levels of investment
(Segelod 2000). In the SI, Brandon-Jones et al. observation of higher-than-
expected levels of capital intensity suggests that the assumption that most
PSOM investment is infrastructural (training, R&D, etc.) may need revising. In
part this observation probably reflects the 20+ year vintage of most service
typologies but the level of capital intensity was also contingent on
organizational scale – the bigger firms spending significant amounts of
communications, knowledge management, project management, etc.
infrastructure (cf. Stratman, 2008; Boone and Ganeshan, 2001). In other
words, the greater levels of concentration (acquisition, merger, etc.) in many
global professional service sectors over the last decade have resulted in
larger firms, and managing their global operations necessitates the use of
techniques more closely aligned to traditional volume practice. Interestingly,
and critically, there are also likely to be significant investment differences
between types of professional service.

In general, surprisingly few of the submissions to the SI engaged with more
strategic technological questions. There has been a recent spate of works
that explore what increasing technological capabilities (and declining costs)
like Machine Learning and Mobile Robotics will mean for various jobs, and
public policy (e.g., Brynjolfsson and McAfee 2014). Of more specific interest
to the challenge of PSOM, Spohrer and Banavar (2015) recently presented a
provocative vision for the use of cognitive computing; arguing that it has
(finally, after a number of false dawns) reached a transformative ‘tipping
point’ with significant implications for a very wide range of work activities.
Their observations resonate with others who have challenged the persistent
value of human judgment in certain tasks. Expert radiologists are routinely
outperformed by pattern-recognition software, diagnosticians by simple
computer questionnaires. Silicon Valley investor Vinod Khosla (somewhat self-
interestedly!) predicted that algorithms and machines would replace 80% of
doctors within a generation. More recently, Gerd Gigerenzer of the Max
Planck Institute argued (Brockman 2015) that in a world where 1 million US
children (annually) have unnecessary CT scans, a Robotic Doctor that could
interpret statistics (unlike many Medical Professionals?), was immune to
conflicts of interest (especially challenging in a fee-for-service system) and
wasn't pre-occupied with “defensive medicine” might provide an improved
service offering.
Control and Quality
We have already indicated that the definition and management of service
quality has some specific attributes in a PSOM setting. If professional service
customers are “typically unaware or imprecise about both what will best
serve their interest and how to go about remedying the situation” (Mills and
Margulies 1980, p. 264) the consequence is that they often assess quality
through other aspects of the service package (e.g. how nice is the office,
how tall is the professional, was I given a medical test, etc.). Others have
argued that ownership structures (in particular the partnership model:

Greenwood and Empson, 2003) might provide a signal of competence and
that the firm will not exploit the client’s inability to evaluate quality.
In the SI, Harvey explores the notion of the customer service experience
during protracted service episodes involving several different types of
professionals over an extended, often multi-year, service episode. Likewise,
Damali et al. present an innovative take on the question of quality and
control by focusing on process effectiveness through the preparation of the
customer. They looked at using customer training and education (CTE) to
improve customer readiness to provide effective behaviors in a professional
service setting, testing their model using survey data from patients diagnosed
with diabetes who had received CTE as part of their healthcare service. They
found that customers who received specific communication from care
providers about what tasks they as customers needed to perform and why
those tasks were important, were able to perform their tasks more effectively.
Their effective task performance led to improved health and lower healthcare
costs.
Professional Service Supply Chains
Finally, although our initial conceptualization was centered on easily imagined
advisor-client dyads, in many settings professional work is undertaken by
teams of knowledge workers, who, even if they nominally share the same
knowledge base (i.e. all heart surgeons) will inevitably disagree about their
judgments (think about the process of journal peer review?) and, in many
cases the parties to any particular judgment process will be from (sometimes
very) diverse areas (e.g., psychiatrist and lawyer?). As such any model of
professional service operations should also include some sense of this
network of professionals contributing to what OM scholars might consider as
judgmental/knowledge supply chains.
Previously, Harvey (1990, p.5) drew specific attention to the challenge of
inter-professional interfaces and in the SI, this theme is the central focus of
the Senot et al. exploration of collaboration between two professional

workforces: physicians and nurses. This multiple-case study, across five acute
care U.S. hospitals, highlighted how physicians and nurses experienced
distinct challenges that act as barriers to collaboration during health care
delivery. Physicians prioritization of evidence-based medicine, what Senot et
al. label their ‘disease-focus,’ acted to undermine more patient-centric notions
of care quality. Nurses conversely, despite their professional status, were
constrained during their interactions with the physicians, a hierarchical
challenge. Although this cliché of the caring nurse and the analytical doctor
is the stuff of endless medical dramas, it does provide a stark reminder that
(a) professionals frequently (normally?) work in collaborative delivery models
and that (b) these can create very challenging operational problems. Senot et
al observe for example that many of the commonly prescribed solutions
(such as multi-disciplinary rounding) were ineffective and highlighted instead
how new forms of collaboration, acknowledging the asymmetries of power
and perspective, could be much more useful.
More broadly, Harvey’s SI paper recognizes that, not only are there
professional service supply chains at work - a pharmaceutical company
building a new plant will need the services of architects, various types of
engineers, chemists, and pharmacists. Insurance underwriters, accountants, tax
specialists, and lawyers are likely to be involved as well, etc. – but that in
such cases we are also considering and dealing with a dynamic and complex
customer system rather than the simplistic idea of the single client. In
exploring these interactions, Harvey builds on the dual perspectives of service
episode and supply chain to propose the notion that professional services
might be usefully understood through the lens of complex adaptive systems.
Extending this network perspective further, Zhang et al. moved beyond the
traditional notion of professional service providers working locally to provide
services for individual customers from a different perspective. They focused
on managing professional service networks on a global scale, specifically
global engineering services (GES).!Drawing conclusions similar to Lawrence et
al, this study emphasizes the importance of establishing common working

approaches, which provides a supportive working environment for innovation,
yet still maintains the necessary autonomy for discretion and judgment.
4. Concluding Thoughts
Above all, the special issue shows that there is significant richness and
diversity to be found in that socially and economically significant set of
activities broadly described as professional services and that the overly
reductive representations of such operations as high variety and/or highly
interactive, misses profound issues of contingency and process. Many key
questions were raised where further research is clearly needed but we
highlight three of particular interest/relevance.
1. Much has been said about the “gentle nudges” that typically constitute
PSOM, but some of the work in the SI suggests that this may be too
convenient a response. Any OM practice that does not consider the
forces at work at the various interfaces is likely to be blind to
leverage points where the right pressure, adroitly applied at the right
time and place, could bring about desired change. Perhaps, rather
than thinking about complex bundles of practice in changing
operations behavior and performance, the PSOM setting will be more
about the strategic introduction of simple rules (Eisenhardt and Sull,
2001, Sull and Eisenhardt, 2012). A focus on the micro-foundations of
professional work could offer some connections to the emerging
Behavioral OM sub-field and generate some fascinating potential
avenues for further practically relevant research. Consider the example
of (medical) checklists applied as a form of ‘pre-operative time-out’ in
Surgery. This apparently simple ‘memory support for critical tasks’
intervention has generated considerable interest and support over the
last few years as a means to improve patient safety in the operating
theatre (e.g. de Vries et al. 2010). The World Health Organization
(WHO) for example is currently promoting the adoption of its own

Surgical Safety Checklist (whereby the anaesthesiologist/anaesthetist
nurse, theatre nurse and surgeon verbally confirm things like the
patient ID, site of incision, planned operation, etc.). Medical and
patient safety researchers have looked at the implementation of the
checklist and indicated that it can decrease complications and the risk
of wrong-site surgery. Could the same technique (itself derived from
similar approaches in the Airline industry) be applied to other
professional settings? What are the specific implementation challenges
of making apparently simple changes to professional routines?
Researchers investigating the application of the WHO Checklist time-
out have also found that “it is not always applied in the way it is
intended” (Rydenfalt et al. 2013). Others (Anthes 2015) point to the
fact that such routinization or task standardization can run the risk of
reducing ownership and investment, which may risk compromising
innovation and judgment needed for the non-standardizable elements
of professional work.
2. The traditional dyadic notion of professional and client needs to be
expanded to acknowledge the complexity of both tight and loose-
coupled professional networks. This surfaces some intriguing variants
on well-understood supply chain challenges, such as the need for
communication, coordination and collaboration, but in a setting where
variable judgment, subsequent conflict, intrusive regulation and
confidentiality are often designed into the process. In exploring these
broader (complex) systems, significant questions regarding unit of
analysis need to be considered.
3. As technologies change traditional information asymmetries and hence
challenge knowledge monopolies, the role of the customer in
professional services will change and, here again, the OM toolset will
need to evolve to better understand collaborative value-co-creation
(Samson and Spring 2012). More generally, questions of automation
and advanced service technologies (cf. AMT?) are under-represented in

the SI and would constitute a significant and timely subject for further
investigation.
Fascinating though such options are, we conclude our commentary with one
key observation. Although some barriers to entry have preserved certain
aspects of their operating models but it is clear that there is constant
evolution in even the most monopolistic settings. Regardless of whether it is
economies of scale, perhaps driven by globalization, government
(de)regulation or (disruptive) technologies that have led service elements to
become more standardized; more standardized, or at least standardizable,
they are hence they can be readily subject to the application of operations
concepts; which as OM scholars know – and the SI shows - can improve
both efficiency and effectiveness.
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