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News Bulletin : ADA News Bulletin November 2010
42 NOVEMBER 2010 more important than their patients'? Perhaps they routinely have critically ill people they are looking after: is this the explanation for their apparently cavalier administration of time? Most likely it's the arrogance of power that determines the attitude that too many in the profession still display in this and other ways. Professionalism is about the delivery of specialized knowledge in a way that balances the attendant power. That is why trust is the essence of professionalism and its most necessary component -- that around which all the other hallmarks of professionalism revolve. The power that asymmetric knowledge gives one person over another must oblige the practitioner to act in the client's best interests. An interesting illustration of this is found in the movie The Doctor. William Hurt's character is a surgeon, flushed with arrogance about his professionalism. He considers it the better part of professionalism to "cut" not "care" and to maintain impartiality towards one's patients to a degree that borders on mockery. He and his fellow surgeons turn music up high once their patients are under anaesthetic; they dance in the operating theatre, making jokes about their unconscious patients during surgery. Only one of the other surgeons does not join in the play. When William Hurt's character discovers he has throat cancer, he abruptly assumes the role of a patient and experiences the arrogance of the surgeons from the other perspective. Like most surgical patients, he is frightened; he confronts his own mortality. He wants the best care he can possibly get, and yet he knows that his surgery has been scheduled for a time of the day when the surgeon will probably notbeatherbest--shewillbeattheendofalonglist,andhe knows, in spite of her protests, that she will not do as expert a job as she might have done earlier in the day. What is more, she is utterly uncaring. She is as icily 'professional' with Hurt as he has been with his own patients. Ironically, he discovers, the person he would most trust to operate on his throat is the doctor who never joked around in the theatre suite -- the serious one who showed respect for the patients he served. Hurt's character concedes that this surgeon is the one he most trusts -- whom he considers most professional. As professionalism proliferates, there will be many people who have knowledge of a particular specialty that is asymmetrical to that of others, and how they treat those others will become more and more important as the power of asymmetrical knowledge passes into multiple hands. Because knowledge is power, true professionals adhere to ethics when dealing with clients in order to harness that power for the good. The medical profession has its Hippocratic Oath and, as we have noted, Harvard MBAs are now taking oaths to ply their trades with honesty and integrity. Perhaps, as the professions proliferate, every group holding specialized knowledge will require an oath or code of ethics that obliges benevolent use of the power that knowledge bestows upon the practitioner. Professional societies and associations play their role in the proliferation of professionalism. Most such associations exist to promote the professionalization and prestige of certain occupations by providing and/or regulating training and some form of certification. These associations are non-profit and are sustained by a combination of the volunteer efforts of members, subscriptions and fees for services. At the same time, professional associations have a strong interest in ensuring that the practice of relevant professions is undertaken by properly trained practitioners so as to enhance the professions' prestige. The effect, in any given case, is to exclude those not sanctioned by an association or by government institutions with which it collaborates. Thus, professional associations both expand and constrict the professions. They also attempt to improve the services offered by professionals through provision of information at conferences, and via newsletters, journals and other publications containing updates in a particular field or pending legislation that may affect practitioners. In some parts of the world, professional associations still set the standards for, and administer the licensing of, their members, and it may fall to such associations to revoke privileges when ethics or standards are breached. Associations, then, wield a significant set of functions as they attempt to preserve the integrity of their professions -- and it is on the effective undertaking of such functions that the acceptance, survival and expansion of the professions will in part depend (for all that the trend is for governments to make concerted efforts to remove the self- regulatory role from the professions). For a profession to be accepted as such, it must generate trust. Practitioners must reassure the public that standards have been met, that proper training has been given, that sufficient knowledge and skills have been attained, and that practitioners will wield their power in a fair and benevolent way. By these standards and by Carr-Saunders' summation of professionalism, more and more occupations will be considered professions as time goes by. With this in mind, I would like to conclude the present section by drawing attention to an everyday scenario. Is it not the case that a certain degree of professionalism is expected from the worker who comes to fix our home electrical system? It is anticipated that this tradesperson will treat the customer and their property with courtesy and respect, will accurately diagnose the problem, will take responsibility for the fact that he or she is dealing with a potentially dangerous, even fatal, situation and will feel an obligation to use his or her expertise to protect us from the effects of the problem. The customer will feel reassured if they know that the repairperson is part of a recognized trade association and bears formal certification. The person has knowledge asymmetrical to the public's when it comes to electrical systems, and the public places trust in him or her, giving him or her power over us. Is such a tradesperson a professional? By some parameters of professionalism, yes. Does the modern tradesperson have more specialized knowledge than, say, the medical doctor during the nineteenth century who 'bled' patients on a theory of 'humours' of the body -- a theory that had not changed since the Middle Ages? Has the tradesperson less practical knowledge than doctors of that era? Lacking any understanding of bacteria, doctors in those times sutured wounds using silk whetted with their tongues to thread the needle, not infrequently killing the patients -- as a result of the ensuing infection -- whom they sought to save. Medicine was such a hit-or-miss occupation that those with dysentery were treated with an array of substances ranging from laxatives to strychnine. Medicine, nevertheless, has never been considered anything but a profession. But the tradesperson -- who also holds responsibility for the lives of the people he or she serves, and is obliged to follow rigorous standards of practice -- is not considered a professional. In the twenty-first century it is not improbable that both a qualified and accredited electrician and an IT technician -- when compared one with the other -- might reasonably be considered neo-professionals. In a world where knowledge is exploding boundaries every few years rather than every few centuries, where knowledge is increasingly accessible to larger numbers of people, where things are so complex as to require specialized expertise to keep a home running safely, there will be more and more occupations entering the ranks of the professions. Continued in News Bulletin, No 394, December 2010. *Source: Professions Australia. Reprinted with kind permission of Professions Australia. References are available on request from firstname.lastname@example.org.
ADA News Bulletin October 2010
ADA News Bulletin December 2010