!!! This is a SiteProxy proxied website, do not enter your personal information. Refer to: https://github.com/netptop/siteproxy for details !!!×
Skip to main content
Springer Nature Link
Log in

Eliot Freidson: Sociological Narratives of Professionalism and Modern Medicine

  • Chapter
The Palgrave Handbook of Social Theory in Health, Illness and Medicine

Abstract

Theoretical analyses in sociological specialist areas such as health and illness are believed to be led by theorising from mainstream sociological thinking. However, in some cases the reverse is evident, such as in the sociology of professionalism, where considerable debate has focused on the changing position of medicine and doctors, which has been characterised by some scholars as the archetype of professionalism. There have been a multitude of theoretical perspectives informing sociological analysis of this topic, but one of the most influential has been the writings of Eliot Freidson, who has been described (Bosk 2006:637) as ‘a founding figure in medical sociology’. This chapter will focus on discussion of some of Freidson’s key concepts which appeared in his earlier work, such as professional autonomy (Freidson 1970, 1975), and more latterly, re-stratification, and in his more recent writings, where Freidson (2001) argued that professionalism is an ideal type of organisation of work (or what he termed ‘a third logic’), where the professional acts as a mediator presiding over the interests of the state or corporate agencies and serving the needs of the public and demands of patients. Freidson was not without his critics (Coburn 2006), and the chapter will examine the merits of some of these critiques. It will also draw on empirical evidence mainly from the National Health Service (NHS), in England, to examine if concepts such as professional autonomy and discretion, re-stratification and trust are salient in sociological explanations of the current position of medicine.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  • Alford, R. (1975) Health Care Politics. Chicago University Press: Chicago, IL.

    Google Scholar 

  • Bosk, C.L. (2006) ‘Review Essay: Avoiding Conventional Understandings: The Enduring Legacy of Eliot Freidson’ Sociology of Health and Illness 28:637–653.

    Article  Google Scholar 

  • Calnan, M. (1982) ‘The Hospital Accident and Emergency Department; What Is Its Role?’ Journal of Social Policy 11:483–503.

    Article  Google Scholar 

  • Calnan, M. and Gabe, J. (1991) ‘Recent Developments in General Practice? A Sociological Analysis’ in Gabe, J.; Calnan, M. and Bury, M. (eds.) The Sociology of the Health Service. Routledge: London.

    Google Scholar 

  • Calnan, M. and Gabe, J. (2009) ‘The Re-Stratification of Primary Care in England? A Sociological Analysis’ in Gabe, J. and Calnan, M. (eds.) The New Sociology of the Health Service. Routledge: London.

    Google Scholar 

  • Calnan, M. and Rowe, R. (2008) Trust Matters in Health Care. Open University Press: Maidenhead.

    Google Scholar 

  • Carr-Saunders, A.M. and Wilson, P.A. (1933) The Professions. Oxford University Press: London.

    Google Scholar 

  • Checkland, K. (2004) ‘National Service Frameworks and UK General Practitioners’ Sociology of Health and Illness 26(7):951–975.

    Article  Google Scholar 

  • Cheraghi-Sohi, S.S. and Calnan, M. (2013) ‘Discretion or Discretions? Delineating Professional Discretion in English Medical Practice’ Social Science and Medicine 96:52–59.

    Article  Google Scholar 

  • Cobum, D. (2006) ‘Medical Dominance Then and Now: Critical Reflections’ Health Sociology Review 15 (5):433–443.

    Google Scholar 

  • Coburn, D.; Rappolt, S. and Bourgeault, I. (1997) ‘Decline vs. Retention of Medical Power Through Restratification: An Examination of the Ontario Case’ Sociology of Health and Illness 19:1–22.

    Article  Google Scholar 

  • Collyer, F.M. (2010) ‘Origins and Canons: Medicine and the History of Sociology’ History of the Human Sciences 23(2):86–108.

    Article  Google Scholar 

  • Dent, M. (2006) ‘Disciplining the Medical Profession? Implications of Patient Choice for Medical Dominance’ Health Sociology Review 15(5):458-4ó8.

    Google Scholar 

  • Elston, MA. (1991) “The Politics of Professional Power: Medicine in a Changing Health Service’ in Gabe, J.; Calnan, M. and Bury, M. (eds.) The Sociology of the Health Service. Routledge: London, pp. 58–88.

    Google Scholar 

  • Elston, MA. and Gabe, J. (2013) ‘Medical Autonomy, Dominance and Decline’ in Gabe, J. and Monaghan L. (eds.) Key Concepts in Medical Sociology. Sage: London, Part 4. pp. 151–155.

    Google Scholar 

  • Evetts, J. (2002) ‘New Directions in State and International Professional Occupations: Discretionary Decision-Making and Acquired Regulation’ Work, Employment and Society 16(2):341–353.

    Article  Google Scholar 

  • Evetts, J. (2006) ‘The Sociology of Professional Groups: New Directions’ Current Sociology 54(1):133–143.

    Article  Google Scholar 

  • Freidson, E. (1970) Professional Dominance. Atherton Press: New York.

    Google Scholar 

  • Freidson, E. (1975) The Profession of Medicine. Dodd and Mead: New York.

    Google Scholar 

  • Freidson, E. (1994) Professionalism Reborn: Theory Prophecy and Policy. Polity Press: Cambridge.

    Google Scholar 

  • Freidson, E. (2001) Professionalism: The Third Logic. Polity: Cambridge.

    Google Scholar 

  • Gabe, J. and Calnan, M. (eds.) (2009) The New Sociology of the Health Service. Routledge: London.

    Google Scholar 

  • Halpern, S. and Anspach, R. (1993) ‘The Study of Medical Institutions: Eliot Freidson’s Legacy’ Work and Occupations 20(3):279-295

    Google Scholar 

  • Hanison, S. (2009) ‘Co-option, Commodification and the Medical Model: Governing UK Medicine since 1991’ Public Administration 87(2): 184–197.

    Article  Google Scholar 

  • Hanison, S. and Ahmad, W. (2002) ‘Medical Autonomy and the UK State 1975 to 2005’ in Nettleton, S. and Gustaffson, U. (eds.) The Sociology of Health and Illness Reader. Polity: London.

    Google Scholar 

  • Haug, M. (1973) ‘Deprofessionalisation: An Alternative Hypothesis for the Future’ Sociological Review Monograph 2:195–211.

    Google Scholar 

  • Horowitz, R. (2013) In the Public Interest: Medical Licensing and the Disciplinary Process. Rutgers University Press: London.

    Google Scholar 

  • Johnson, T. (1977) “The Professions in the Class Structure’ in Scase, R. (ed.) Industrial Society: Class Cleavage and Control. Allen and Unwin: London.

    Google Scholar 

  • Kelleher, D.; Gabe, J. and Williams, G. (eds.) (2006) Challenging Medicine. Routledge: London.

    Google Scholar 

  • Kuhlmann, E. (2006) ‘Traces of Doubt and Sources of Trust: Health Professions in an Uncertain Society’ Current Sociology 54(4):607–620.

    Article  Google Scholar 

  • Kuhlmann, E. (2008) ‘Governing Beyond Markets and Managerialism: Professions as Mediators’ in Kuhlmann, E. and Saks, M. (eds.) Rethinking Professional Governance: International Directions in Healthcare. The Policy Press: Bristol, pp. 45–60.

    Google Scholar 

  • Larson, M. (1978) The Rise of Professionalism: A Sociological Analysis. California University Press: Los Angeles.

    Google Scholar 

  • Larson, M. (2003) ‘Professionalism: The Third Logic’ Perspectives in Biology and Medicine 46(3):458–62.

    Article  Google Scholar 

  • Light, D. (2010) ‘Healthcare Professions, Markets and Countervailing Powers’ in Bird, C.; Conrad, P.; Fremont, A. and Timmermans, S. (eds.) Handbook of Medical Sociology. Sixth edition. The Vanderbilt University Press: Nashville.

    Google Scholar 

  • McDonald, R.; Checkland, K. and Harrison, S. (2009) ‘The New GP Contract in English Primary Health Care: An Ethnographic Study’ International journal of Public Sector Management 22(1):21–34.

    Article  Google Scholar 

  • McKinlay, J. (1977) “The Business of Good Doctoring or Doctoring as Good Business: Reflections on Freidson’s View of the Medical Game’ International Journal of Health Services 7(3):459–488. See also in the same edition of the journal a comment in response by Freidson (pp. 485–486) and further rejoinder by McKinlay J (pp. 487–488).

    Article  Google Scholar 

  • McKinlay, J. and Arches, J. (1985) ‘Toward the Proletarianisation of Physicians’ International Journal of Health Services 15(2):161–195.

    Article  Google Scholar 

  • McKinlay, J. and Marceau, L. (2002) ‘The End of the Golden Age of Doctoring’ International Journal of Health Services 32:379–416.

    Article  Google Scholar 

  • Morgan, M.; Calnan, M. and Manning, N. (1985) Sociological Approaches to Health and Medicine. Routledge: London.

    Google Scholar 

  • Navarro, V. (1976) Medicine Under Capitalism. Prodist: New York.

    Google Scholar 

  • Navarro, V. (1988) ‘Professional Dominance or Proletarianization? Neither’ Milbank Memorial Quarterly 66(2):57–75.

    Article  Google Scholar 

  • Nettleton, S. (2013) The Sociology of Health and Illness. Polity: Cambridge.

    Google Scholar 

  • Nettleton, S.; Burrows, R. and O’Malley, L. (2005) ‘The Mundane Realities of the Everyday Use of the Internet for Health and Their Consequences for Media Convergence’ Sociology of Health and Illness 25 (6):5 89–60 7.

    Google Scholar 

  • Parsons, T. (1951) The Social System. Routledge: London.

    Google Scholar 

  • Pollock, A. and Price, D. (2011) “The Final Frontier: The UKs New Coalition Government Turns the English National Health Service over to the Global Health Care Market’ Health Sociology Review 20(3):294–305.

    Article  Google Scholar 

  • Spyridonidis, D. and Calnan, M. (2011) ‘Are New Forms of Professionalism Emerging in Medicine? The Case of the Implementation of NICE Guidelines’ Health Sociology Review 20(4):394–409.

    Article  Google Scholar 

  • Timmermans, S. (2008) ‘Professions and Their Work: Do Market Shelters Protect Professional Interests?’ Work and Occupations 35(2): 164–188.

    Article  Google Scholar 

  • Willis, E. (2006) ‘Introduction: Taking Stock of Medical Dominance’ Health Sociology Review 15(5):421–431.

    Article  Google Scholar 

  • Witz, A. (1992) Professions and Patriarchy. Routledge: London.

    Book  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Kent, UK

    Michael Calnan (Professor of Medical Sociology)

Authors
  1. Michael Calnan
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Sydney, Australia

    Fran Collyer (Associate Professor) (Associate Professor)

Copyright information

© 2015 Michael Calnan

About this chapter

Cite this chapter

Calnan, M. (2015). Eliot Freidson: Sociological Narratives of Professionalism and Modern Medicine. In: Collyer, F. (eds) The Palgrave Handbook of Social Theory in Health, Illness and Medicine. Palgrave Macmillan, London. https://doi.org/10.1057/9781137355621_19

Download citation

Publish with us

Policies and ethics