The Rise of Professionalism: A Sociological Analysis

By Magali Sarfatti Larson | Go to book overview

Chapter 10
PATTERNS OF PROFESSIONAL INCORPORATION INTO THE NEW CLASS SYSTEM

Professionalization generally implies that status is chosen over class as a mode of approaching social reality and acting upon it. This choice is one of the principal roots of the professions' overall conformism with the social order, though by no means the only one. Going from the general background to specific examples, we must consider now how the "model" professions of medicine and the law sought to insert themselves in the upper rungs of the status system.


MEDICINE AND THE COHESIVENESS OF ECONOMIC INTEREST

In the age of laissez faire, American medicine had been particularly weak in organizational resources, by comparison with other professions. Incipiently bureaucratic organizations did not confer upon it the legitimacy of capitalist property, as they did for engineering and the commanding sectors of the law. Nor was medicine unified by an autonomous bureaucratic hierarchy, as were certain branches of the clergy. The elite of physicians -- those connected with urban hospitals, public office, or the most reputable medical schools -- led the attempts to unify the profession and raise its very low standards in the early part of the nineteenth century, as they did later. But the professional societies did not yet have sufficient power to enforce cognitive unification, which was indispensable in an extremely competitive market.

Thus the profession that would one day come to symbolize unparalleled professional power had, on the average, low standards, low status, low income, and low social credibility as late as the turn of the century. In 1896, "One doctor, writing in the Pittsburgh Medical Review, lamented that it was 'humiliating to make a comparison of the economic and social positions of our leading physicians and surgeons ...with leading lawyers and other professional men.'"1 While the official Journal of the American Medical Association declared in 1905 that "the standing and influence of the medical profession depend on the material success and financial inde

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