Managerial Organization and Professional Autonomy: A Discourse-Based Conceptualization

Abstract

The conceptualization of professions and professionalization is once again a significant theme in the social sciences. The position of professions seems increasingly complex as relations with other occupational groups develop in ways that seem uncertain, ambiguous and complex. We present a discourse-based framework for the analysis of professional change, drawing on Chouliaraki and Fairclough’s critical discourse analysis (CDA), and their adaptations of the work of Laclau and Mouffe, and Bhabha. The model focuses on the articulation process within conjunctures of social practice, and in particular how social actors endeavour to make advantageous articulations which achieve a degree of permanence in an inherently changeable world. It also considers how discourses are articulated together to create hybrid forms of professional discourse. We apply the framework to recent changes in the role and autonomy of general medical practitioners in the United Kingdom following the implementation of the clinical governance system, to assess the value of the framework in addressing the negotiated nature of professionalism and, more specifically, to explore the relationship between managerialism and professional autonomy and status.