Marlot Kuiper

44 Connective Routines Knowledge that is ‘esoteric’, because it is specialized and takes time and effort to acquire. It requires long-lasting, specialized training to gain such a ‘technical base’ (Freidson, 1970; Wilensky, 1964). In the case of medical doctors, these skills enable them for example to diagnose and treat (Starr, 1982). These bodies of knowledge are linked to central needs and values of the social system. The ethical dimension (cf. Starr (1982) who calls this the ‘moral’ dimension and Wilensky (1964) who speaks of a ‘service ideal’) refers to the devotion of the professions to the service of the public, above and beyond material or financial incentives (Evetts, 2002). Physicians for example, have to be devoted to the medical service and put the interests of their patients above their own (Starr, 1982). This ethical basis creates trust in the profession, which is crucial to the physicians’ status in society (Mechanic, 1996). Trust in the profession relates to the third dimension; the regulatory dimension (cf. Starr (1982) who refers to the ‘collegial’ dimension and Larsson (1977) who refers to an ‘evaluative’ dimension). Traditionally, professions can be seen as groups of workers who control themselves (Evetts, 2003b, 2011; Freidson, 1994, 2001). Professions themselves determine who may legitimately become ‘member’ of the profession, and they regulate their own professional behaviour, for example by means of their own disciplinary jurisdiction (Wilensky, 1964). They determine professional qualifications, set up training and education programs, and develop codes of conduct. By investing in education, associations and codes of conduct, professions secure both the ‘technical base’ of their profession a as well as its ‘service ethic’ (Wilensky, 1964). By investing in jurisdictions, backed by state regulations, they secure professional autonomies (e.g. Abbott, 1988). On the one hand, professionals are granted collective autonomy over the processes, procedures and content of their work. The more standards are set by occupational fields, the stronger these professionals are in terms of their autonomies and power (Noordegraaf & Steijn, 2014). On the other hand, professionals have individual autonomy in the application of their profession’s body of knowledge; their professional judgment. Because of the firm belief that individuals outside the profession do not possess the specialized knowledge required to evaluate the practices of professions, professionals proclaim that they are in the best position to operate, control, and regulate their own practices (Freidson, 1988).