CRPL Research Tea - Professions as Politics: the Medical Profession and its End in the United States, 1783-1860

In a striking case of professional collapse, the medical profession in the United States gave way to a raucous free market for healthcare around the middle of the nineteenth century. To explain the causes and consequences of these events, we draw on insights from political sociology to probe the origins of opposition to the medical profession. Dominant professions must both maintain cultural authority over potential rivals and secure the support of state officials in order to maintain their advantages. We argue that the cultural and institutional power of a dominant profession can be overturned if challenger occupational groups organize and mobilize actively, and if populist political coalitions find that anti-professional sentiments resonate with the electorate. Moreover, each of these processes can reinforce the other, lending the normally staid world of professions the character of a contentious social movement arena. Our analysis contributes to sociological knowledge of the professions by demonstrating that the loss of professional power is not simply a case of professionalization in reverse. Instead, political dynamics within professional and political ecologies can give rise to insurgent forces that challenge the foundation of professional power.