Marlot Kuiper

45 Standardization in professional settings Most of this ideal typical professional public service delivery in Western welfare states (such as the Netherlands) occurred within large bureaucratic organisations. Clarke and Newman (1997) speak of bureau-professional regimes. Within these regimes, trust marks the relationship between the various actors. First of all, autonomy was granted to the professions by the state. Secondly, the assumption that professionals can be trusted to perform in the best interest of their clients, and thus of the organisation, makes that there are not well-developed systems of bureaucratic control within organisations (Brock, 2006), nor is there much interference from colleagues. The relationship between professionals, employers and peers is thus characterised by trust and confidence (Evetts, 2011). The professional bureaucracy, then, does not rely on the formalisation of work processes or bureaucratic controls to ensure high quality of service delivery. Rather, it depends of the standardization of skills, internalized values and what Ouchi (1980) called ‘clan control’ (Brock, 2006). Table 1: The classic model of professionalism Dimension Description Cognitive Technical base; ‘esoteric’ knowledge acquired through enduring specialized training. Ethical Service ideal; devotion to serving the public good. Regulatory Self-controlling; control over content of work, processes, and procedures, as well as autonomy in the application of specialized knowledge. Bureau-professional regimes Bureau-professional organisations. Relationship between state and occupation based on trust. Autonomy granted to occupation. Trust and confidence characterising the relations between professional/employer, professional/client, and among peers (‘clan control’) 2.2.2 Becoming a professional In treating complex, unique cases, professionals thus rely on a cognitive base, an ethical base and the regulatory space to make decisions based on their professional judgment. As argued, these ‘skills’ are acquainted through enduring training. It is important to look at the ways that professionals are trained to work (together), since this forms an essential step towards an in-depth discussion of professional work in relation to working with standards later in this chapter. I provide such a description, confined to the medical profession, by subsequently discussing socialization, specialization and segmentation. 2