Indiana Law Journal

Volume 64 | Issue 3 Article 1

Summer 1989

Theory and the Professions

Eliot Freidson
New York University

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Freidson, Eliot (1989) "Theory and the Professions," Indiana Law Journal: Vol. 64 : Iss. 3 , Article 1.
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 Theory and the Professions
ELIOT FnEIDsoN*

INTRODUCTION

I have been asked to appraise the idea of profession, its usefulness in

analyzing particular kinds of occupations, and the direction that further
research and theorizing might take to improve its usefulness. Let me begin
with the idea of profession itself.'
Some, both sociologists concerned with theory and critics of the perform-
ance of particular occupations that have claimed professional standing, have
argued that the word has little value for distinguishing among analytically
different types of occupations except insofar as it involves a mark of social
prestige, a claim to dignified status. 2 To debunkers, this means that the
word is merely a symbolic facade that obscures the fact that occupations
using it are no different than any others. This conclusion is manifested
more explicitly among those inside and outside the professions who have
urged antitrust and other actions designed to remove any special legal
privileges based on distinguishing "professions" from "trade" or "com-
merce".' To them, "commercialism" in the professions is no pathology but
rather confirmation of their essential similarity to other occupations in that
they, too, are concerned primarily with gaining a living in the marketplace.
That position is not untenable, but it so simplifies the issues as to
impoverish what and how we think. It ignores any possible significance of
differences among types of work, the kinds of knowledge and skill needed
to perform particular kinds of work, the various kinds of training or
education required for the work, the organization of occupations, the
relation of occupations to others in a division of labor, and the relations
of occupations to their clients, and to the state, corporate capital, and the
public.

* Professor of Sociology, faculty of Arts and Sciences, New York University.

1. I make no effort in this article to provide an exhaustive list of references. However,
at appropriate places I shall cite key references to especially influential works, the more recent
of which have useful bibliographies.
2. In her very important and influential book, Larson seems to conclude that the
professions no longer have in reality any distinction other than prestige. See M. LARsON, THE
RISE OF PRoFaSSIoNAIsM 232-37 (1977).
3. A good recent source containing some papers expressing this position is REGuLATiNG
THE PROFrSIONS (R. Blair & S. Rubin eds. 1980). It is also implied by critical writers like
Abel, Why Does the ABA PromulgateEthicalRules?, 59 TEx. L. REv. 639 (1981) and Moore,
Professionalism Reconsidered, 1987 AM. B. FouND. REs. J. 773 (1987).
 INDIANA LAW JOURNAL [Vol. 64:423

Without distinguishing such differences, there is only the simplest kind

of economic thinking to serve as a conceptual guide for analysis. Everything
is reduced to the least common denominator of crude, material self-interest
exercised in an imaginary free market. Since empirical differences are too
important to ignore in practical policy discussion, however, whatever is
ignored by that least common denominator gets drawn into discussion on
an ad hoc and unsystematic basis, sometimes overtly and sometimes as
underlying and unacknowledged assumptions.
This is not a healthy intellectual position. What is needed for analysis is
a systematically interrelated set of comprehensive even if not exhaustive
criteria by which we can distinguish among occupations in consequential
ways. Ordinary use of the term by either lay people in general or those
engaged in policy-related dialogue tends to focus on only one or two criteria
depending on the context of discussion. Thus, professions are distinguished
by some as being dedicated to public service rather than being concerned
only with their own economic interest like other occupations. By others
they are sometimes distinguished as being singular by virtue of the special
kind of education and knowledge and skill that their members possess.
This is not enough, however. Even if the two criteria together might be
used as keys to others, the arrangements and circumstances that make them
possible have to be specified and their roles elaborated systematically. Thus,
it is almost meaningless to invoke serving the common good rather than
personal interest without at the same time specifying the conditions (such
as a reasonably secure income) that support the very possibility of doing
so. The concept of profession must be articulated systematically, and not
represented by only one or two key ideas. This is not to say that one cannot
articulate it through one or two key ideas-something that I shall myself
do here.

THE ELEMENTS OF OCCUPATIONAL CONTROL OVER WORK

What are the elements that ought to be included in such a systematically

developed concept? They are determined in part by the issue one puts at
the center of the analysis-the key element to be explained. The choice of
such a key is of course arbitrary. For myself, 4 what professions have in
common with all occupations should be the starting-point for analysis.
Professions are occupations, and occupations are productive pursuits by
which people gain their living in the labor market. One can differentiate
among occupations, however, in a number of ways. One can focus on

4. The following sketch is being developed in a more elaborate way in a work in progress
tentatively titled, Professions and the Fate of Knowledge, to be published by Polity Press,
Cambridge (U.K.).
1989] THEORY

variation in the way their relation to the labor market is structured. Or one
can differentiate them by the nature of their productive pursuits-that is,
the kind of work their members perform and the way they perform it. And
one can differentiate occupations by control-who controls or commands
the determination of what the work shall be, and how it shall be performed
and evaluated.
My preference is to take this third element as the central focus. I start
by defining a profession as a kind of occupation whose members control
recruitment, training and the work they do. This explicitly distinguishes
occupational control from industrial or collective worker control, the former
being limited to particular, demarcated tasks and the latter embracing the
overall organization of a division of labor without controlling specialized
tasks.
Since the historic crafts share that characteristic with the professions,
however, further differentiation is necessary based on the knowledge and
skill involved in work. Like the crafts and unlike those kinds of work that
are regarded as unskilled or semiskilled, professional work is represented as
work that requires the exercise of discretionary judgment. Unlike the crafts,
however, it is considered to be work that requires formally organized,
theoretical or abstract knowledge for its adequate performance. That knowl-
edge requirement in turn distinguishes the kind of training and the way it
takes place. For both craft and profession, training is controlled and
conducted by members of the occupation. For professions rather than crafts,
however, training is heavily weighted by book learning. It characteristically
takes place today in an institution of higher education where theory is
taught formally. Substantive knowledge and skill may be taught both in
school and afterwards in practical work-settings. In the crafts, training
characteristically takes place on the job rather than in school, and is based
more on practice than on theory or book-learning.
This characteristic of training in a school creates and sustains a special
role within the professions that is missing from the crafts-namely, members
of the profession whose job it is to train recruits in professional schools.
When that job is full-time, those faculty members are freed from the
demands of making a living by practice in the marketplace and can engage
in research or scholarship and in the elaboration of the profession's ideas,
knowledge, skills and procedures. This provides professions with an advan-
tage over the crafts in that by institutionalizing research and scholarship in
this manner they are in a better position to control their own body of
knowledge by undertaking their own innovations. The crafts must constantly
defend their jurisdiction against incursion by innovations and substitutes
created by outsiders.
Control over training for a particular kind of work can be sustained only
if there is sufficient control over the labor market to provide a living to
 INDIANA LAW JOURNAL [V/ol. 64:423

those with such exclusive training.5 Thus, an essential element to include in

the systematic articulation of a theory of professions lies in postulating
some consequential form of labor market control by the occupation. A
variety of methods is possible, but near-exclusive jurisdiction 6 by members
of the occupation over particular kinds of tasks is essential so that only
they have the right to perform them. Certification by an accepted agent of
the occupation that an approved course of training was successfully com-
pleted is a common prerequisite for being admitted into this controlled
labor market to gain a living.7 This in itself restricts the amount of
competition for available positions, though those admitted may have tO
compete with each other for the more desirable positions. Another prereq-
uisite for full occupational control is officially enforced or customary
understandings that only members of the profession may supervise and
evaluate the work.

THE ELEMENTS FOR GAINING AND MAINTAINING CONTROL

These interrelated elements involved in a system in which workers exercise

control over their own work allow us to see the dimensions of the system,
but do not allow us to understand how such a system could come into
existence and how it can be maintained. It represents, after all, a privileged
position for labor in the marketplace, virtually a monopoly. The vast
majority of all occupations lack such a privilege. Why a monopoly for
professions or, for that matter, crafts? A systematic conception of profes-
sions must be able to answer that question.
Occupational control of work is an alternative to either control by
consumer demand in the marketplace or control by some central authority
like the state or the management of firms. In order to control their work,
workers must block the desire of both individual consumers and officials
or executives of organizations to use whomever they please to perform
particular tasks and to evaluate the performance of that work by their own

5. Abel, following Larson, takes control of the relative number of professionals competing
in the restricted labor market as his key criterion. See Abel, supra note 3. This criterion
emphasizes the importance of the relative amount of economic reward available to members
of the profession. Unlike Abel, and holding in mind professions other than law and medicine,
I assign less theoretical significance to the size of economic rewards, which is a function of
restricting the number of credentialed professionals, and more to the security of rewards,
which is a function of restricting the right to work and to supervise workers to those with
credentials, no matter what the number of professionals competing with each other for available
rewards.
6. An important recent work seeking to explain the development of occupations by
focusing on the establishment and defense of jurisdictional boundaries is A. ABBOT, TEE
SYsTEM OF PROFESSIONS (1988).
7. For an analysis and description of the credential system sustaining the professions in
the United States, see E. FREmsoN, PROFESSIONAL POWES (1986).
1989] THEORY

criteria. This requires the exercise of power, but apart from the military,
the police, and some criminal vocations, occupations have no real power
of their own. They have only their knowledge and skill. Knowledge and
skill can influence others, but only if others believe in their value. In order
to gain a privileged position in the marketplace an occupation must persuade
those who do have the power to grant and sustain it. However, in order to
negotiate with the powers that be, an occupation cannot be a mere aggregate
of workers or practitioners. It must be an organized corporate body, one
that in the United States takes the form of a private professional association.'
Given such formal organization it is possible for an official leadership to
speak for and represent the members of the occupation whether they belong
to the association or not. The leadership of professions performs the task
of persuading those who possess power-most particularly the state-that
members of the occupation are worthy of their protection and support. And
the association also undertakes activities designed to influence legislative
and other policies that bear on its members' interests.9
The task of persuasion is a complex one and includes the generation of
a number of rhetorical claims and institutional practices that ordinary
occupations do not ordinarily display. Some rhetorical claims stress the
special character of the tasks performed by the profession-their more than
ordinary value to civilization, to individuals and their problems, and to the
political economy as a whole, and the dangers to civilization, individuals
and the political economy should they. be permitted to be performed by
non-professionals. Others stress the claim that the body of knowledge and
skill employed by the profession is so complex and esoteric that lay people
are not able to employ it themselves, and are not able to evaluate how well
those with professional training use it. Thus, consumers would not be able
to protect themselves by their choices in a free market-members of the
profession must be trusted to protect them by their own dedication, self-
discipline and mutual evaluation.
Claims about the profession's knowledge and skill are not enough for
gaining support, however. A monopoly controlled by those who possess it
is not likely to be willingly and deliberately granted without some belief
that it will be used in the public interest rather than for purely selfish
purposes. Those seeking such a monopoly, therefore, must be persuasive in
claiming characteristics that discourage its abuse. It is in that context where
we must place the claim that professionals are, unlike ordinary workers,
more devoted to the good of their clients than to their own material interests.
In their arguments to gain the power to control their own affairs, or to

8. A dated but still major source on professional associations in the United States is C.
lILa, HIDDEN HInAa~cmas (1966).
9. For a recent study of the activities of an association of the Bar, see T. HALLIDAY,
BEYOND MONOPOLY (1987).
 INDIANA LAW JOURNAL [Vol. 64:423

defend the power they already have to do so, the representatives of profes-
sions claim that recruitment into their profession selects those who have
qualities that resist the abuse of privilege, and that this "altruism" is
reinforced by the manner in which they are trained and by the way in which
the organized profession functions after training in the world of practice.
Empirically, the particular content of those claims to trust varies. At one
time the family and ethnic origins, religion, class, gender and race of recruits
were employed to assure the "good character" required for assuring dedi-
cation to the public good. Lately the stress has been on selection by
universalistic criteria of competence, which itself seems to require placing
less emphasis on character and more on the content of the training of
recruits, and most particularly on training in ethics and professional conduct.
But whatever else, claims have also included assurance that once training is
completed, only those capable of competent and ethical practice are per-
mitted to enter the labor market, and that the profession supports institu-
tional procedures that discourage the abuse of public trust among its
members and that undertake to exercise effective disciplinary action against
those who do so. Formal codes of ethics are often promulgated both to
demonstrate concern with the possible abuse of privilege and to provide
guidelines for evaluating and taking action against it. One of the duties of
the profession's leaders is to periodically make speeches reaffirming the
profession's resolution to sustain high ethical standards of performance that
justify the public's trust.
The claims of professions are rarely, if ever, matched by their actual
performance. It is that mismatch which is pointed to by both those who
wish to eliminate professional privileges entirely and those who speak for
competing occupations seeking for themselves a portion of the privileged
jurisdiction controlled by an established profession. There can be little doubt
that the greater the public perception of gross deviation of professional
performance from professional claims, the less can professions resist pressure
to weaken their monopoly, but the class standing of professionals and their
leaders, the caution of those in power, the almost universal dependence of
large, complex societies on credentials for determining the qualifications of
those who do complex work, and the ambiguity of evidence bearing on that
deviation make for rather slow changes in professional privileges. Sweeping
changes have occurred only following revolutions, and even then, histori-
cally, professional privileges have been reinstituted in virtually every case.

CLIENTS AND POWER

This sketch of the interrelated elements that distinguish the professions

from other occupations is not particularly original, synthesized as it is from
19891 THEORY

the work of many other scholars. 10 It does, however, provide a framework,

an institutional and historic context by which we can then make sense of
the more concrete questions we wish to raise about professions. I believe
that it can more or less serve to characterize all occupations falling into the
category. But when we turn to examine professional work itself, we must
distinguish the consequences of there being different kinds of professional
work and differently organized labor markets. While professions may be
said to share certain claims, aspirations and institutions, they differ in other
respects. Some professions command bodies of knowledge and skill that
serve the needs of individual clients while others serve the needs of insti-
tutions, organizations or aggregates of individuals: most physicians are
found among the former while most engineers and professors are found
among the latter. Lawyers, as Heinz and Laumann's recent study of the
Chicago Bar has reminded us," are divided between those who serve
primarily the former, and those who serve primarily the latter.
An additional characteristic of considerable importance for determining
what kind of work is done and how it is done lies in the organization of
the profession's clientele. If clients are relatively few in number, sophisti-
cated, well-organized and politically or economically powerful, the capacity
of members of a profession to select the work they do and determine how
they do it is markedly limited: their clients will call many of the shots. On
the other hand, if clients are many, unorganized, heterogeneous and indi-
vidually without significant resources of individual power, professionals are
in a better position to call most of the shots. Thus the paradox that Heinz
and Laumann noted: Members of the most affluent, prestigious and influ-
ential hemisphere of the Bar, in large law firms serving corporate capital,
have less power over their clients (and presumably less leeway to determine
how they practice) than do those in the other hemisphere of considerably
less prestige who serve the needs of individuals and small businesses in local
neighborhoods.1 2 This suggests that the content of some of what is deplored
as "commercialism" may stem from acquiescing to the concrete demands
of clients rather than being an invention by professionals responding to
economic incentives alone. Certainly that is the case for some of the
"commercialism" to be found among physicians today, for powerful third

10. Key past works on professions (aside from the author's) are E. CARR-SANDERS & P.
WnsoN, THE PROFESSIONS (1933); E. HuGHEs, THE SOCILOGICAL EYE (1971); T. JOHNSON,
PROFESSIONS AND POWER (1972); M. LARSON, supra note 2; W. MOORE, THE PROFESSIONS:
ROLES AND RuLEs (1970); Goode, The Theoretical Limits of Professionalization,in THE SEIni-
PROFESSIONS AND THEm ORaANizATIoN 266-313 (A. Etzioni ed. 1969); Parsons, Professions,
in 12 INTERNATIONAL ENCYCLOPEDIA OF THE SOCIAL SCIENCES, 536-47 (D. Sills ed. 1968);
Parsons, The Professions and Social Structure, 17 SocIAL FORCES 457-67 (1939).
11. J. HEINz & E. LAUMANN, CHICAGO LAWYERS: THE SOCIAL STRUCTURE OF THE BAR
(1982).
12. Id. at 360-73.
 INDIANA LA W JOURNAL [Vol. 64:423

parties who now pay the bills of individual patients have deliberately
designed reimbursement policies that stimulate and exploit purely commercial
incentives.

PROFESSIONAL PRACTICE

The most important question to ask about professions is how and why
their members do what work they do the way they do, which leads us to
the analysis of professional work itself and its organization into professional
practice. Practice is the ultimate test for the claims of professionalism, for
it is there where the work of professions takes place, and where it is done
well or badly, ethically or unscrupulously. But what do we mean by practice?
My comments on the importance of clients for shaping the work of
professions have treated practice as if it could be understood only as an
interpersonal relationship-the relationship between an individual profes-
sional and an individual client or representative of an organization. Indeed,
this is the usual way we think about professional work. Most of the
conventional literature on the professions is dominated by the image of an
individual, self-employed practitioner who works alone in his own office
serving individual clients in his community. Those who deplore the present
state of their profession use that image to represent what existed in the
nineteenth or early twentieth century and what has been lost to us today.
This is not a very useful image against which to compare what is going on
today, in part because it has not been conceptualized adequately and in
part because, empirically, it applies to only a few professions and, even for
them, by no means all their members.
In any case, solo practice itself is not merely a relationship between a
professional and successive individual clients. It is a form of organization,
to be understood only in part as the relations an individual practitioner has
with individual clients. It is also a way of organizing work that could not
exist without being embedded in a system of professional institutions that
protects and sustains it. And it is an organized node or point in a community
network of relations among clients and prospective clients, in a professional
network of colleagues, and in an organized division of labor that includes
members of other occupations whose cooperation is necessary for both
receiving clients and dealing with their problems effectively. Unfortunately,
in spite of the nostalgic attention it receives, we have very little good,
empirical information about solo practice in any profession. 3
Solo practice is of course only one way of organizing work. Salaried
practice is far more common in most professions. There are many studies
of the state agencies, hospitals, schools, churches, and universities that

13. For solo legal practice, a virtual classic is J. CAxuN, LAWYERS ON TiEiR OwN (1962).
1989] THEORY

employ many professionals from which we are able to infer something of

value about the way their work is organized, but little information has been
gathered specifically about professional practice in such organizations. Fur-
thermore, much of the available information is superficial, composed as it
is of such gross data as the number of professionals in practice units, their
status as employees, partners or owners, probationers, or whatever, their
differential incomes, the nature and volume of the cases they deal with,
and the like. The significance of such data is not self-evident. To make
much sense of it requires extensive interpretation, and for that we have to
rely on only commonsense knowledge, intuition, and "background knowl-
edge" based on personal experience. In spite of their patently limited
perspective and frequent conflict of interest, professionals themselves dom-
inate the interpretation of such data.
By and large, I think it can be said that the information we have for all
professions shows a major deficiency. For most professions there is a
reasonable amount of information about their associations and their activ-
ities, their professional schools and training programs, and their bodies of
knowledge and skill. For all professions, however, the information we have
on practice-the organization of professional work and the way it is
performed-is by far the weakest. This deficiency is critical because the
very justification for the market protection that associations, schools and
credential systems provide lies in the actual work that professionals do. And
it is only by a close and systematic look at professional practice that we
can understand what work is done, how and why.

THE NEED FOR FIRST-HAND S DY OF PRACTICE

It is true that there seems to be an enormous amount of information

available about professional practice. Trade journals publish a great deal
of information about the activities of professional firms and their personnel
policies, as do the major newspapers of the nation. Historians have taken
up the professions with gusto, and in the case of law in particular, more
than one writer has published books providing detailed description of the
activities of lawyers. 14 And of course we have a great deal of material in
the form of journal articles, speeches and memoirs produced by members
of the professions themselves. But this is by no means enough. To analyze
a practice systematically one must show how it is set up as an organization,

14. For law firms see, e.g., J. STEWART, Ti PARTNERS (1983). Compare its content,
organization and focus with that of R. NELSON, PARTNERS Wrr POWER (1988). For an
extensive bibliography of past work on the legal profession, see Abel, The Sociology of
American Lawyers: A Bibliographic Guide, 2 L. & PoL'Y Q. 335-91 (1980), and the recent
review and annotated bibliography in J. FLOOD, THE LEGAL PROFESSION IN THE UNTED STATES
(3d ed. 1985).
 INDIANA LA W JOURNAL [Vol. 64:423

the lines and focal points of authority, how authority is exercised, over
whom and over what facets of their work, how the division of labor is set
up and coordinated, the pattern of informal (i.e., unofficial) interaction
and influence among its members, the characteristic problems and conflicts
experienced by members serving in different positions in the practice and
performing different kinds of work, and much more.
Above all, adequate understanding requires first-hand observational and
interview data self-consciously collected by an outsider. Without a detached,
ethnographic account of professional practice, both our knowledge and our
capacity to interpret the data we have are grievously handicapped. Without
it, our knowledge is limited to topics that happen to attract public attention
and our interpretations limited by either the diffuse framework of common
sense thinking or by the inevitably partial and self-interested perspectives
of members of the professions. While those concerned with understanding
the past have no alternative but to depend on the highly selective docu-
mentary material that has survived the past, we are in a position to generate
new material about practice today in our own way for our own needs.
First-hand study of the various forms of professional practice is a critical
requirement for developing not only better understanding of the professions
but also sensitive and intelligent social policies for dealing with them.