Professionalism: The Third Logic (review)

Eliot Freidson's goal in this book is to trace an ideal type of professionalism, like the ideal types of the free market and of the rational-legal bureaucracy (p. 179). Freidson sets professionalism next—in fact, against the logic of the market and of bureaucratic managerialism—as the third organizing principle of the division of labor. Only professionalism, he argues, is truly capable of handling special knowledge, knowledge that is esoteric not because it is secret, but because it is specialized and takes time and effort to acquire. A book that constructs an ideal type is, almost by definition, not a passionate book, nor one brimming with empirical references; it is substantial but tends to be general and abstract. This book imparts wisdom and strength to the author's defense of "the third logic," while also hinting that it may be his ambition to bring a revised sociology of work closer in intellectual prestige to economics and administrative science, the disciplines founded on the other two logics.

What, then, is the logic of professionalism? Freidson postulates that it needs to be rooted in "a set of interconnected institutions providing the economic support and social organization that sustains the occupational control of work" (p. 2). On the one hand, what happens to these institutions (and, in fact, their very form) has direct effects on professionalism. On the other hand, since there is more to professional control of work than its defining characteristic of monopoly, we are led to ask whether professionalism survives if it loses what Freidson calls its "soul" (p. 180), which implies a sense of practical and institutional ethics.

For Freidson, professional control is legitimately monopolistic because it governs a special knowledge that society (or, rather, some more-or-less representative elites) values enough to want advanced and applied in socially useful ways. The carriers of that special knowledge therefore deserve to be sheltered from market laws and reasons of state. Freidson presents, first, the structural underpinnings necessary to the logic of professional control: specialized knowledge, protected jurisdiction, orderly careers in a sheltered market, professionally controlled training, and a special ideology. Second, he considers the institutional contingencies that decide whether an occupation is more or less able, in a given historical context, to approximate the ideal type: the type of state (to which we could add particular political climates) and the kind of special competence, of knowledge and skill, that a profession claims. Lastly, he illustrates how these contingencies have transformed American medicine in the 20th century.

Professionals claim competence, and on this basis special protections and privilege. These claims are signaled in labor markets by legitimate credentials; training and its institutions, therefore, have primary and paramount importance for professionalism. Freidson begins, however, with a general discussion of the different levels of knowledge and skill marshaled by a profession in action, suggesting that these may be in tension.

Commonsense knowledge is ineluctable for professionals as for other members of their society and culture, but it is largely unconscious and heavily marked by inequalities of gender, race, and class. Professionals, no matter how specialized their knowledge, can seldom free it from the culture's stereotypical assumptions, even if they had the will and the time. But knowledge is specialized with regard to something, Freidson observes—which opens up for consideration the complex and continuous process by which both applied and academic professions construct the boundaries of a field and mark it as their own. Deepened and expanded out of its original field, this is the formal and codified specialized knowledge that training centers transmit. Formal and tacit knowledge pose different problems of social access: not only is the system of professional education stratified in terms of resources and prestige, it also opens up for the candidates different trajectories and possibilities of experience and practice. Freidson insists that training systems and their control give professions their...