Changing Professional Autonomy in the Context of Institutional Change
Kragh Jespersen, Peter
Economics, Politics and Public Administration Aalborg University Aalborg, Denmark
Houlberg Salomonsen, Heidi
Economics. Politics and Public Administration aalborg University Aalborg, Denmark
Professions act in strongly institutionalized contexts which affect and regulate their rights, duties, roles and autonomy but are at the same time institutional actors affecting the institutional context (Scott 2008) in order to protect professional autonomy. Because of this changes in professions and their autonomy are partly explained by influence from changing institutional contexts and partly by deliberate and strategic professional reactions. This is well known in the literature on professions and institutions ( Kuhlmann 2006, Leicht & Fennell 2008). What haven't received sufficient attention is how different types of institutional contexts and changes within these affect different professions autonomy? And how these changes are affected by different types of professions? We will address these questions by exploring: how changes in different institutional contexts affect the autonomy of two different types of professions. And secondly explain the reactions by the two professions in general, and reactions in order to preserve their autonomy in particular. These questions are explored empirically by a comparative historical case-study of Danish medicine and civil service
The paper is based on Hargrave and Van de Ven's recent typology of institutional changes (2006), supplemented by the concept of institutional logics (Friedland & Alford 1991). The general idea is that initial institutional change will affect the autonomy of the professions, causing professions to react in order to preserve their autonomy and affect the institutional changes in favour of their profession.
The paper has an explanatory ambition using a comparative case-design, designed to identify the causal mechanism(s) whereby institutional changes affect professions' autonomy (Gerring 2004; Tsoukas 1989).The causality suggested in the model are complex, as the causal relation between professions? autonomy and institutional changes is reciprocal as changes in professions' autonomy also potentially affect the institutional changes, as professions act strategically in order to preserve their autonomy. Hence a main expected theoretical contribution of the empirical analysis is not the identification of an expected co-variation between various types of institutional change and autonomy, but the identification of different roles of the professions in the process of institutional change, when explaining how different types of institutional change affect professions' autonomy.