The paper presents a synopsis of an analysis within a theoretical framework of sociology of professions on the rise of the professional field of Health in Sweden. The study is a part of large scale comparative case study with cases from six professional fields and 18 occupations using mainly secondary data.
The paper presents a synopsis of an analysis of one branch in the field of health, namely the legitimate medicine and its core profession – the physicians, and some of their subordinates – nurses and biomedical scientists. The narrative of the rise of the field of health and the legitimate medicine in Sweden is underpinned by historical studies (mainly secondary data) and departures from the state formation process in Sweden in the 1500’s into the neoliberal state of today. The analysis revolved around; the development of a specific medical science and specific professional knowledge as a legitimizing resource as well as paradigmatic and cognitive elements in nosologies, professionalization strategies and jurisdictional claims, conflicts and solutions. As an overarching frame these processes are analyzed in relation to the progressing, expanding and differentiating health care system and state administration structures. The social, political, technical, historical and economic aspects forms a web of conditions for the rise of the field of medicine as a whole, but also differentiating conditions for branches in medicine, whereas some was more successful in their professionalization strivings than others such as the legitimate medicine or in other words the biomedical body medicine. The study is a part of a large research project Carriers of Knowledge Society: A Study of the Historical Emergence and Contemporary Importance of the Swedish Professions founded by The Swedish Research Council (Vetenskapsrådet), which is a large scale comparative case study of 18 occupations within six professionals fields, in terms of a structured, focused, comparative case-study (George and Bennet 2005). The fields are Health, Social control, Social integration, Education, Academia and Technology, each field have three occupations from different generations of professions (classical, semi- and pre-professions, see Brante 2010) and are analyzed by a number of shared clusters of questions.
A reconstruction of four periods was done; 1) The rise of the state medicine and the pre-professional era 1600-1850’s 2) The biomedical paradigmatic shift 1860-1920’s, 3) The professional golden age and emerging effects of rationalization 1930-1960’s 4) The withering welfare state and challenges to professionalism 1970-2000’s. These phases roughly correspond to periods of: 1) Establishment of a field, 2) Qualitative, or cognitive, take-off, 3) Quantitative take-off and cultural hegemony, 4) Subordination to external governance; loss of autonomy and transformation of professionalism. The time span in question is extensive but stretches into the 1990’s in general and some passages even into 2010’s. Due to limited space in the article format nurses and biomedical analysts will be discussed in relation to state interventions in shaping new jurisdictions and in general with less detail than the medical profession. The analysis is a reconstruction of the development of a specific medical science and professional knowledge as legitimizing resources, professionalization strategies and jurisdictional claims, conflicts and solutions. It also entails analysis of paradigmatic and cognitive elements in professional knowledge system. These processes are analyzed in relation to the organization of the health care system and state administration structures from the 16th century to present time. Broadly, the analysis shows a close relation to the peak of professionalism in the field of Health to the culmination of the prosperity of the welfare state.
professions fields medicine doctors nurses biomedical analysts historical sociological science
Paper presented at the conference Professioner - Gamle autoriteter og ny legitimitet Det nordiske netværk i professionsforskning, NORPRO, 25-26 oktober 2012, VIA University College, Aarhus, Denmark.