What’s “professional” got to do with it anyway?

A lot actually, I’m glad you asked.

The word itself has shifted meaning over time, as words do, and in common parlance these days I think it’s fair to say many people think ‘profession’ simply means your employment.

That is a common usage of the word and is not incorrect. However that is not how I mean it here. I use the word profession in it’s more traditional sense. Webster’s 1828 Online Dictionary’s second definition of the word profession carries the original flavour still:

2. The business which one professes to understand and to follow for subsistence; calling; vocation; employment; as the learned professions. We speak of the profession of a clergyman, of a lawyer, and of a physician or surgeon; the profession of lecturer on chimistry or mineralogy. But the word is not applied to an occupation merely mechanical.

Contemporary Merriam Websters Dictionary states:

c (1) : characterized by or conforming to the technical or ethical standards of a profession (2) : exhibiting a courteous, conscientious, and generally businesslike manner in the workplace

A 12th century Byzantine manuscript of the Oath in the form of a cross

Earlier uses of the word profession include three singularities that I think make professions distinct from other pure forms of income. The idea of “professing” (from the Latin to profess ) of making a public oath, describes the significant detail of making a public declaration to abide by the protocols of training in one’s discipline. This is critical to my understanding and use of the word profession today because that act of declaration is essentially a promise to the public to adhere to the principles of the training of their field and not be swayed by personal or otherwise unregulated interests. This is not a requirement for many forms of employment. As a shoe shine gal you may expound freely on your personal take on best treatments for corns, to cancer without recrimination, because your view on health care is not the service your customers pay you for, and you are not bound to only express opinions on shoe shining.

The act of oath saying or making pubic avowals is still prevalent in many professions today, particularly in the field of medicine or any discipline where the greater good of humanity’s interests are at stake. Similar to the Marriage ceremony, the statement made aloud of life long devotion to the mate, witnessed by others to be made legit; symbolizes a promise.

The Hippocratic Oath is a well known example of this, still practiced by physicians today who swear to follow the ancient ethical code, originating in the late 5 th century BC.  Although the origninal translation is still used by some, more common are modern versions, like the main rewrite  – the Declaration of Geneva – from 1948 which still  includes among other points: swearing to be true to the principles of science, equal treatment to all classes of people, (slave or free) no sexual or amourous contact with patients, protection of client privacy, not deceiving the patient.

Accoding to Wikipedeia

 In a 2000 survey of US medical schools, all of the then extent medical schools administered some type of profession oath. Among schools of modern medicine, 62 of 122 used the Hippocratic Oath, or a modified version of it. The other 60 schools used the original or modified Declaration of Geneva, Oath of Maimonides, or an oath authored by students and or faculty. All 19 osteopathic schools used the Osteopathic Oath.[14]

With whom does the RESPONSIBILITY lie for safe, effective delivery of the service one professes to offer? That is exactly the question. If you are one of the professional class the responsibility is squarely yours, not your employers, not your governing board, nor your Association, it’s on you. The opposite is true with non professional employment, where the employee is but doing the will of the company. If MacDonald’s coffee is too hot to be safe say, and it burns a customer, that company can be and has been, sued for making an unsafe product available to the public. But it was the company that was held accountable, not the employee who served the coffee. Restaurant jobs are not professions. Are you with me?

The second identifying element is the  reference to standards of training. Traditional professions have exhaustive educational requirements which leave little room for influence by current public trends. Trends come and go quickly. Standards take a long time to establish and do not shift frequently or with ease. That’s the trick to standards, if everyone abides by the same ones, they come to mean something in the public’s eye. TRUST is built. If one group refuses to adhere to the collective standard, or wants their “own version” ( hello Quebec?!) it throws a spanner in the works and standards become relative; this has the effect of lowering public trust in the said standard.

Can there be problems with the establishment of and adherence to standards or with the standards themselves? Absolutely, but the reality is we live in societies and agreeing upon some basic rules of responsibility is wise and intended to be helpful in creating accountability. In our personal behaviour, we chose to obey the speed limit on roadways because the potential risk of travelling at higher speeds is increased. Same with professional obligations, the purpose of establishing baselines for best practices is intended to keep overall risk lower.

Do we ever get rid of risk, of course not. Sheesh. However I still find nobility in the attempt to maintain networks of protection to the public and accountability of actions. Do we fail at that even, heavens yes. Look no further than Dr. Oz. But I digress.

To set a standard implies that core curriculum is agreed upon and delivered in same or similar fashion, broadly. Clearly, it is no small feat and cannot happen overnight. Standards reflect the work of many vested interests and parties across large geographies to get their most important ducks in a row, to compile and implement best practices. Best practices in western medical terms means reliance on empirical science (measurable stuff.)   Usually (always?) formal exams or dissertations or some intense level of PROVING ones facility with the content of study is required, in order to acquire the designation. For instance you can spend years studying law but if you do not pass the qualifying exams at trainings end, you cannot place those letters after your name.  It’s not enough to learn it, you have to prove that you learned it well. It’s not a ‘training on the job’ type scenario with professions, you are hired (if you don’t work for yourself) because, you already possess the skills for the job.

The third element that I think makes professions distinct from other work is the inclusion of ETHICS. There is a deliberate inclusion of moral code to the very thread of the discipline. This doesn’t mean it has to be “good” or “godly” work in and of itself – although clergy is considered a profession.  It means that the work delivered must serve the best public interest. i.e. build that bridge – good. Build it so it doesn’t collapse and hurt someone – better.  “For profit” operations, of which there are many, are not professions. Many job sectors exist simply to make profit and are obviously not operating with a moral code at their foundation. I don’t mean to suggest to profit you inherently have to be an immoral operation, nor to suggest that you cannot make a profit as a professional but you can see the conflict inherent in the balance of offering your best work, with the opportunity to make the best money. 

Your signature is your word.

I know an Engineer (a regulated profession) who takes his oath to heart and feels challenged in his corporate position to apply his signature (his mark) to work he does not feel he has had sufficient time to review. In the corporate climate where expecting inhuman work hours is the norm, along with an unmanageable work load; he is frequently in this uncomfortable position. He feels professionally compromised by the profit goals of his employer who wanted the job done last week, and his professional code of ethics which requires his work does not harm the public. If the bridge fails, it is the Engineer who risks losing his right to practice his work, not the corporation he works for. His signature is his word, his vow that he has done his job to the best of his training so the public can trust his work.

Explain regulation please.  To do justice to this would take too much space here, I will summarize it by saying that Regulation implies there is a body who oversees the professionality of the practitioner.  Most often they exist to maintain and enforce compliance to the standards governing that field of work, and to protect the public from rogue practitioners who may not comply.  Regulations can be governmental or private, and are specific to the profession. If a complaint arises from a client, say the bridge collapses and hurts someone, that someone can seek remediation or investigation of the accused professional by the regulatory body overseeing that field of work. If found at fault, the professional can face their designation being removed, lose their positions at the firm, face big fines, be called in for review or made to recant faulty studies. The most common form of public protection these days is in the form of Malpractice Insurance.

Let’s recap shall we? The so called “Learned Professions” means: after passing standardized training, one declares/signs an oath, to stick to training, and use it for the best of human interests. More than just a pay cheque I’d say. I do think this puts professions in a different category of work, don’t you?  Remember not all white coats denote professional designation, do your due diligence.

Unsure if your health care providers are “professional” or not?  Ask if they have malpractice insurance. That’s always a good start to a long answer.