Marlot Kuiper

50 Connective Routines and it is argued that such media incidence caused an erosion of trust in public professionals (Millenson, 2002; Evetts, 2002). Because of market-driven managerialism, the demand for multidisciplinary action, the changing role of patients, severe media attention and so on – it is argued that a growing role of employing organisations like hospitals, and external forces like media, healthcare inspectorates and accreditation boards, increasingly subject medical doctors to financial incentives, fierce market competition and the erosion of trust. The classic model of professionalism is therefore no longer tenable in describing contemporary practices (Evetts, 2011). 2.3.4 New models of professionalism The outlined developments have consequences for professional work itself, professional-employer relations, professional-client relations, and for the control of work priorities and processes (Evetts, 2011; Noordegraaf et al., 2015). These accounts of change describe a shift from long time notions like partnership, autonomy and trust to notions of managerialism, standardization, assessment and performance review (Evetts, 2011). This shift challenges Freidson’s defining characteristic of a ‘third logic’ as a means of controlling professional work, as professionalism no longer seems a distinctive third logic, but increasingly includes logics of the organisation and the market such as managerialism and consumerism (ibid). A lively theoretical debate ensued, in which scholars identified different directions for ‘professionalism’. ‘De-professionalisation’ First of all, there are claims of ‘de-professionalisation’. Managerial performance assessment and target-setting are considered an assault on professional power. Freidson (2001) for example stressed that values prominent in an ideal typical ‘professional logic’ are increasingly oppressed by a ‘managerial logic’ encompassing organisational values (see also Reay & Hinings, 2009). He argued that the profession “is seriously weakened in the name of competition and efficiency” (Freidson, 2001, p.3). Others added to this by stating how the effects of the New Public Management turned professionals into ‘occupational professionals’ that face organisational control (Exworthy & Halford, 1999). From this perspective professionals are theorized as being severely challenged and even threatened by organisations. Professionals are regarded as passive ‘victims’ who are relatively powerless against demands for more transparency and accountability (Evetts, 2011). In short, outside control of professional standards is considered challenging for professional autonomy and power. The