In a healthcare setting, deprofessionalization decreases the knowledge or skills of a single
profession and breaks it into multiple professions (Science direct, 2021). An example of
deprofessionalization in a healthcare setting is breaking a medical physician into a
secondary unit called a medical assistant. Another example of deprofessionalization is a
laboratory technologist job broken into units called laboratory technician and laboratory
assistant. These secondary units would not eliminate the original healthcare profession.
Healthcare organizations will continue using deprofessionalization in the industry. With
the staffing shortage is on the rise, the healthcare industry believes that creating secondary
units of a profession would make more people work for a certain position without
extensive training. Another reason why healthcare organizations would continue using
deprofessionalization in the future is to reduce the cost of care (Reed, 1987). The cost of
healthcare is steadily rising, and many people cannot afford to seek any medical services.
When using a secondary medical professional, it would allow the patient to receive
medical treatment at a lower cost. One effect of deprofessionalization is the low level of
trust that patients given to secondary healthcare professionals. When a patient receives any
medical treatment from a medical assistant or a technician, they do not believe that they
are receiving the proper care that they should be receiving.
Deprofessionalization' is the idea that there is a shift from professional to nonprofessional
status and the decreasing distance between doctors and patients with knowledge and
education, generally in reference to the rise of consumerism in healthcare (Coburn 2001).
Although there is a shift in medical power deprofessionalization in healthcare is generally
used when discussing in medical knowledge. The managed care expansion in healthcare is
a pivotal point when physicians began being referred to as providers, patients became
consumers, and the deprofessionalization of medicine also took a turn (Kaufman 2011).
This change also brought about a change in the doctor-patient relationship and the
hindrance to the medical professional’s ability to perform their jobs as before. It seems
that the managed care companies seem to be part of the deprofessionalization in that they
are sort of pulling the strings on healthcare and limited both patients and doctors (Marlow
1997). Physicians acquire their knowledge and subsequent access to evidence-based
practice information that is grounded in science to provide them power, autonomy, and
wealth all things associated with professionalism. Physicians are losing their power as the
healthcare industry continues to shift to one of corporate management and profit-making.
These changes takeaway the physician’s ability to be "altruistic servants" specifically with
incentives to reduce treatments for money, the loss of camaraderie and cohesive health
care, and not using their medical knowledge to their greatest capabilities.
The deprofessionalization of medicine may also be contributing to the burnout of
professionals because of the health care working conditions (Duvefelt 2016). The
continuing decrease in a sense of power and skill is also putting a strain on professionals
and pushing physicians out of the field or making them want to quit in higher and higher
numbers. In medicine people tend to be driven by innovation, continuing education with a
deeper dive into knowledge, improved expertise, or a change in population to help stave
off mundane work life and burnout and decrease the sense of powerlessness.
The original profession is still there along with the knowledge and the skills but medical
professionals are limited by managed care and patients. Their power and knowledge is
diminished and stunted by the current structure to healthcare. With the potential for a
universal healthcare in the not-too-distant future it would be interesting to see how
professionalism responds to the changes. If physicians might be able to obtain and
improve on their sense of power, autonomy, and professionalism.
"Deprofessionalization refers to the decreasing distance, in knowledge or education,
between doctors and patients or the rise of consumerism generally" (Haug, 1975).
Medicine is now becoming another exchange of goods and services (Smith, 2016). Many
times, in the profession, providers are required by law to go against their personal beliefs,
morals, and values to accommodate the people of their facility. This term symbolizes roles
of customers instead of patients. An example would be a patient requesting an act of
euthanasia because they no longer want to live life and the provider has to abode by the
patient's wishes, not what they feel is best for the patient (Smith, 2016). As we continue in
medicine, deprofessionalization will continue at an even more rapid pace because it
becomes more prevalent over time. Medicine in my opinion, has become more political
rather than serving the needs of the patients. "The secularists don’t think it is wrong to
force doctors to participate in life-taking or religiously proscribed procedures" (Smith,
2016). This means that if a patient believe they should live, the doctor must do everything
in their power to ensure they keep them living, but they may not agree and the patient's
wishes may not come true.
The idea of deprofessionalization involves lowering certain government-imposed
requirements that individuals must obtain prior to practicing in the industry. This can be
done by offering different third-party certifications rather than solely government-imposed
certifications. These certifications, according to Svorny and Cannon, “would allow
innovative educational and certification programs, nontraditional career paths, incremental
expansion of clinician skills and scopes of practice, and the creation of new categories of
health care professionals. The result would be better career opportunities for clinicians and
greater access to care for patients.” (Svorny & Cannon, para. 3, 2020). While different
responsibilities are taken away from certified practitioners, one can argue that they were
overqualified to be doing such menial tasks anyway. With deprofessionalization, tasks
such as drawing blood can be passed on to individuals who are right-skilled to draw blood.
This frees up the practitioner to focus their resources onto more important tasks.
Not only do resources become better allocated, deprofessionalization creates more
competition in the healthcare industry. Competition is key for industry growth.
Government licensing constricts competition as each facility must meet the same level of
high standards, therefore leading to them performing at an expected level. Giving facilities
the opportunity to use third party certification may allow for different configurations of
care to arise. The Federal Trade Commission comments on the benefits of competition;
“Competition in America is about price, selection, and service. It benefits consumers by
keeping prices low and the quality and choice of goods and services high.” (FTC, para. 3).
Different configurations of care become available as there are no more government-
imposed regulations. The market ultimately decides which facilities will strive in this new
system. If America wants to follow a true ‘free market’ healthcare system, this is one way
to do it!
It is hard to say if this approach will be ever taken in this country. Personally, I like the
idea and believe that the healthcare system would benefit drastically from
deprofessionalization. Epstein proposes one argument discussing the topic of medical
professionals becoming obsolete. He writes; “The threat to the professional stature of
physicians became more direct now that management skills and technical prowess
progressed to the point where it made it possible to standardize other tasks which were
traditionally reserved for the professional judgment of senior medical personnel” (Epstein,
p. 68, 2013). The government has such a strong hold on the healthcare industry that it is
difficult to see them letting this happen. There are many hurdles that must be taken prior to
deprofessionalization becoming a reality!
Deprofessionalization includes the rationalization of knowledge, the rationalization of task
which employ knowledge, and the growth of various tools to assist in applying knowledge.
The theory behind this concept is that the more task which are compartmentalized the
more knowledge-based tools can be applied. An example of this theory applied to health
care is the registered nurse (RN) position. The RN is always going to be needed in
healthcare and even more so during the current shortage. “They assess and identify
patient’s needs and then implement and monitor the patient’s medical plan and treatment.”
Over the years deprofessionalization has occurred within the nursing umbrella. This has
resulted in additional roles being established which include nursing advance practice
registered nurse, licenses practical nurse, registered medical assistant, certified medical
assistant, medical assistant, certified nursing assistant, and nursing assistant (Writers,
2021). All these roles have different task which are also part of the RNs role profile. In
healthcare deprofessionalization is used to help support a role by establishing specialized
careers/responsibilities.
The other side of the spectrum shows concerns that deprofessionalization can lead to
corporate micro-management of physician work and establishing more control over what
physicians do and how they do it. “This includes decreasing distance, in knowledge or
education, between doctors and patients.” The bureaucratic impact on the industry has led
to growing pressures of reorganization within the health care division of labor to improve
efficiency. This has the potential to weaken the medical monopoly structure (Kritzer,
2001). As healthcare organization continue to restructure due to resizing, budgeting,
change in patient demographic will lead to more deprofessionalization as organizations
look to add jobs with specific job requirement such as education, certifications, and job
experience. The era of organizations only having ‘traditional’ healthcare roles is over as
organizations look to add more and more specialized positions to the payroll.
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responsibilities
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FTC. (n.d.). Competition Counts: How Consumers Win When Businesses Compete. FTC.
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