In the health care setting, deprofessionalization refers to the process in which an
individual makes a shift from a professional status to a non-professional status.
Thus, this takes place when doctors become less of physicians and more of service
providers for the patients. Due to such a trend, patients are considered to be the
customers of these service providers. The concept of deprofessionalization in the
health care setting does not eliminate the original profession of the individuals.
This is because they continue to make use of their knowledge, skills as well as
expertise while interacting with their customers and delivering services to them.
Technically deprofessionalization can be defined as the loss of the distinctive
occupational qualities that an individual possesses. However, in the health care
domain, deprofessionalization does not lead to loss of health care-related skills and
knowledge by doctors. They continue to use these skills and capabilities while
interacting and engaging with the service users (Deprofessionalization.
Deprofessionalization - an overview | ScienceDirect Topics, 2021).
In the future deprofessionalization in health care would not lead to the elimination
of the original profession of health care professionals such as doctors. This is
because the deprofessionalization process cannot lead to the removal of the years
that doctors have gone through in the medical practice in order to acquire
knowledge and education relating to health care aspects. In the professional sense,
their mode of delivering their services might change in the future. However, it
cannot lead to the loss of the education and training that they have obtained over
the years while studying in the health care discipline. The concept of consumerism
is likely to continue to mold the relationship that exists between patients and
doctors by leading to the decrease in distance between them (Coburn, 2015). Even
in the future, deprofessionalization in the health care setting cannot lead to the
elimination of their original profession and the acquired skills.
Hi all, so before I comment on my opinion of deprofessionalization, it is important to
understand exactly what this means for healthcare professionals. Basically, the more tasks a
person can take on, without studying fully for it, as a doctors or nurse would do, the more the
doctor and nurse become deprofessionalized, or deskilled from their occupation. This can also
be defined as "the decreasing distance, in knowledge or education, between doctors and
patients". (Kritzer, 2001) We have seen this happen with the new positions dwindling down
from an MD, to a Physician assistant, to a Nurse Practitioner, to a Registered Nurse, a
Licensed practical Nurse, and so on. Basically, we take more away from the doctors, and give
the task to the next person under him, however, the original profession does not get
eliminated. I think a lot off this has to do with the lack of access to care for some
communities, and the shortage of healthcare professionals in the country. This allows for the
population to be able to see other professionals, rather than the doctors. I haver seen this
happen a lot lately, especially because we have been having many clinics opening, and a
majority of them have P. As or nurse practitioner working., The doctor is still the head boss,
and the final person who makes the final decisions, however, the PAs are the ones seeing the
patients. It is almost as if the doctor has changed to doing only surgeries, and administrative
work.
I do not believe this will change soon. I believe this is the new way of healthcare. People will
most likely see the nurses for check-ups and problems, and defer to the doctors for more
serious problems, like surgeries. With the increase in adults ages 65+ needing healthcare, and
the shortage of healthcare workers, I believe this will be an ongoing thing for a while.
As we are all aware, there is currently a severe staffing shortage in the healthcare industry
which is unlikely to be solved overnight. Although deprofessionalization can assist with
this crisis, it will not be a long term solution nor will it eliminate the need for healthcare
providers. Despite the current staffing crisis, the healthcare industry continues to evolve
and changes. One aspect of deprofessionalization that can have a significant impact in the
healthcare industry is the incorporation of artificial intelligence.
As technological advancements continue to emerge, there will be a need to adapt to
increased demand, healthcare trends, and competition within the industry. Technology has
a significant impact on accessibility to care and the use of artificial intelligence could aid
in streamlining healthcare accessibility and workflows. Currently, medical literature notes
that the use of artificial intelligence is limited to cancer, neurology, and cardiology
treatment, however, with additional development it could potentially assist with
automatically notifying healthcare providers of abnormal results or processing medication
refills (Jiang et al., 2017)
There are incentives for healthcare systems, patients, healthcare providers, and
pharmaceutical companies to utilize artificial intelligence, however, there are limitations
that could impact successful implementation and long term success. In order for artificial
intelligence to be successful, there must be continuous learning from clinical studies and
research to adapt to healthcare trends, federal rules, and regulations (Jiang et al., 2017).
Artificial intelligence systems must possess the ability to analyze structured data sources
in the form of imaging studies, genetic and electrophysiological data while simultaneously
being able to extract information from clinical notes and medical journals (Jiang et al.,
2017). Artificial intelligence systems are typically classified as "general wellness
products," however, there are currently no regulations in place to assess the safety and
efficacy of these systems (Jiang et al., 2017). If artificial intelligence systems are not able
to readily adapt and are deemed safe, patient health outcomes, medical treatment
efficiency, and reimbursement could be impacted (Jiang et al., 2017). At the end of the
day, although “artificial intelligence [can] substitute some tasks, complement others, and
create new tasks,” artificial intelligence is a mere compliment to not a replacement for
human intelligence and does not eliminate the need for health profession (Sako, 2020).
In health care, deprofessionalization occurs when there is a change in the skill sets
that are specific to that profession. "Deprofessionalization refers to the decreasing
distance, in knowledge or education, between doctors and patients or the rise of
consumerism generally." (Coburn). For example, most hospitals currently in the
U.S. are under-staffed on qualified physicians that are overworked. PAs, NPs, and
LPNs help to fill the gap in patient care by instead of their original role of working
alongside a provider, they now have the professional freedom to care for patients
themselves. This saves the hospital on payroll costs and gives the patients faster
care using a distribution of power and resources but it might not be the best
quality care compared to an experienced and more educated provider in a
speciality. This does not eliminate the original profession of a physician but I fear
in the future quality care may be compromised to save on healthcare costs by
hiring cheaper labour.
Another issue in professionalization in health care is the internet. "The Internet
constitutes a new and unique medium which expert knowledge is accessible to
anyone with a computer linked to a network or modem. Medical dominance is
challenged not only by exposing exotic medical knowledge to the public gaze but
also by the presence of a wide range of information about and approaches to
health." (Hardey). Websites like WebMD and blogs are becoming more popular to
the public as an option to self-diagnose symptoms instead of paying for a doctor
visit and insurance. This can potentially lead to chronic illnesses. I am guilty of
googling my symptoms sometimes when I feel sick or off to save time going
making an appointment and driving to the doctor's office. I had pain in my lower
back one time and google said it could either be a sore muscle, a bulging disk, a
kidney stone, or cancer! The results were so extreme and vague I decided to go to
the doctor and it turned out to just be a tight muscle from working out. But some
people might read those other possible diagnosis and get scared or try to self-
medicate with other approaches to health for a condition they don't even have,
while the real problem is slowly getting worse. The internet is packed with an
overload of information and a lot of times it is made up. I do not think the internet
will eliminate the profession of a physician either, in fact, I think in the future more
patients will seek quality care by choosing to go to an educated professional
versus internet blogs or they could even video chat with their doctors at the
convenience of their homes.
“A Profession comprises of a group of people who have special knowledge and
skills in a widely recognized body of learning derived from research, education and
training at a high level and are guided by a code of ethics, and who are prepared to
apply this knowledge and exercise these skills in the interest of others” (Australian
Council of Professions, 2003). Deprofessionalization happens when there is a
change in the skills or qualities that are unique or specific to that profession.
In the United States there is a shortage of health care providers, and which
has led to new roles for allied health providers. Nurse Practitioners and Physician
assistant (PAs) roles were designed initially to work alongside physicians to
complement the care provided, but with the shortage of Physicians these
professionals are given more autonomy and, in many states, allowed to practice
independently. More and more complicated patients are assigned to Nurse
practitioners and PAs and are allowed to do procedures which in the past would
only be done by a Physician with extensive training. More and more non physician
providers are providing care beyond their experience and training. We are seeing a
deprofessionalization of Physicians by insurance companies, health care industry
and corporate entities that would like to cut down costs by hiring more Nps and
PAs than Physicians (Balon & Morreale, 2022).
There are other medical professions also that face shortage of qualified health care
providers and might have to rely on less qualified professionals to deliver health
care services like shortage of RNs and medical social workers and may have to use
more LPNs (licensed practical nurses) and instead of graduate social workers, may
have to rely on undergraduates to deliver services.
Despite de professionalization of health care, the original profession still has its
dignity and value. But there is a concern if quality will be compromised in the
future for profit and cost concerns.
Australian Council of Professions. (2003). What is a profession? Retrieved from
https://www.professions.org.au/what-is-a-professional.
Balon, R., & Morreala, M.K. (2022). Demise of a Physician. Annals of Clinical
Psychiatry. 34(1), 1-3. Retrieved from https://www.aacp.com/wp-
content/uploads/2022/02/0222-ACP-Editorial.pdf
Coburn, D. (2001). The Medical Profession. International Encyclopaedia of the
Social Behavioural Sciences.
Hardey, M. (1999), Doctor in the house: the Internet as a source of lay health
knowledge and the challenge to expertise. Sociology of Health & Illness, 21: 820-
835. https://doi.org/10.1111/1467-9566.00185 Retrieved from:
https://onlinelibrary.wiley.com/doi/epdf/10.1111/1467-9566.00185
Engelhardt, H. T. (2002). Managed care and the deprofessionalization of medicine.
In The ethics of managed care: professional integrity and patient rights (pp. 93-107).
Jiang, F., Jiang, Y., Zhi, H., Dong, Y., Li, H., Ma, S., Wang, Y., Dong, Q., Shen, H., &
Wang, Y. (2017). Artificial Intelligence in healthcare: Past, present and future. Stroke and
Vascular Neurology, 2(4), 230–243. https://doi.org/10.1136/svn-2017-000101
Sako, M. (2020). Artificial Intelligence and the future of professional work.
Communications of the ACM, 63(4), 25–27. https://doi.org/10.1145/3382743
Kritzer, H.M (2001). Science Direct. "Deprofessionalization- an overview." Retrieved from
https://www.sciencedirect.com/topics/social-sciences/deprofessionalization
Coburn, D. (2015). Medical Profession. https://doi.org/10.1016/B0-08-043076-
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