Harvey L. Smith
The modern professions are complex social institutions which select people of varied skills, often from several social strata, and organize them into different levels of operation and diverse interest groups. Each level and group may be sensitive to contingencies not shared by the profession as a whole. Thus different parts of the profession may "metabolize" at different rates, and any single action may have many, diverse, and often conflicting effects within the professional institution. In addition, our complex modern professions have multiple relations, directly and, through their professional associations, with other occupational groups and with the public. Here, too, there are important problems of differential sensitivity. Such problems are highlighted during periods of professional change. We will review these problems as they involve the following: professional associations, environing professions, resistances within the profession, professional fictions, the role of the public, and professional skills.
Within the profession there may be wide divergence of aims between rank-and-file members and their professional associations. The personnel of such associations may be selected from among the avant-garde, the future-oriented members of the profession. They may demand changes in the profession's status and remain insensitive to those of their fellow members whose security systems are rooted in the status quo. Or, like other human institutions, the professional associations, regardless of the need that they arose to fulfil, often develop a desire to perpetuate their own existence and behave in ways not necessarily those of the profession they represent.
Another problem may arise when the professional association tends to represent one interest group within the profession rather than another --the teaching group, for example, rather than research or service. In such a case important components of a profession may remain effectively disenfranchised at the level of professional politics.
The rank-and-file members of a profession may be caught in the cross fire when the directives of their associations are too greatly at variance with the aims of other professions in a shared working situation.
It is, for example, an excellent thing for a society of pathologists to insist that hospital pathologists are clinicians and should have ready access to the bedsides of living patients. Current medical understanding of the