Defining a profession
Eric K. Curtis, DDS
Credentials are on the rise. Not so long ago, less than ten percent of Americans finished college. These days, according to a recent poll, almost a quarter of all people in our workforce count themselves "professionals." Yet some observers, citing a proliferation of non-university-trained occupations that would claim the title—swimming pool professionals, say, and dog grooming professionals—think the word profession has suffered name inflation.
At the same time, longstanding applications of the term have declined. Along the road to managed care, for instance, health care professionals turned into health care providers—a trick of egalitarian etymology designed to redistribute medical authority, ostensibly from doctors to patients but in fact from both parties to third party payers. As a result of this one-word switch, the medical profession became medical provision, mere labor input into the production of a commodity.
With such blurring of lines, how do you define a profession? The question is more than academic. What we accomplish as dentists depends on our understanding of who we are. Some would say a profession is defined by money; a professional golfer is simply one who is paid. Others cite status. "Is advertising a profession, like law and medicine?" asks University of Texas advertising professor Jef I. Richards. "How many new parents clutch their babies to their breast and declare, ‘I want this child to grow up to be a media planner’?" Still others suggest that a profession holds special knowledge and abilities. In The Bridge Between Two Lifetimes, Scottsdale, AZ, therapist Marilyn Powers explains, "If you have a toothache, you just don’t stop the pain by yourself. You find a professional you can trust, someone who knows exactly what needs to be done."
An actress I know says that professionalism is not a question of status or compensation, but commitment. History bears her out: The word profession originally meant "public declaration," and originally had to do with taking the vows of a religious order. In medieval Europe, priests and monks might be thought of as the first professionals. Indeed, many of the early universities were founded as theological schools. But from the 16th century, "profession" was used in a broad sense to mean any calling or vocation—in short, a job. By the 18th century, the definition was again more specific. In 1733, Samuel Johnson’s dictionary defined a profession as a calling, but particularly one of three: divinity, physic (medicine) or law.
Before the Industrial Revolution, a profession was based on social status rather than performance of useful work. During the Industrial Revolution, the professions came to be strongly focused instead on specialized knowledge and the ability to perform related tasks.
Medieval society considered dentistry, as it did all surgical specialties, a trade. Pierre Fauchard redefined dentistry as a profession by calling for three ingredients: formal education, literature (especially journals to more quickly diffuse new ideas) and licensure. He also demanded occupational celibacy. Many early dentists combined their work with other pursuits, including gold and silver smithing, even the ministry. Like the old monks, to be professionals dentists had to commit to their calling.
Lately the description of a profession has evolved into more nuanced lists. In Dental Ethics at Chairside, David Ozar and David Sokol write that a profession has certain characteristics accepted by both members of the profession and the public: 1) its practitioners have education beyond the ordinary, both theoretical and practical; 2) its particular expertise is a source of benefit for those who seek its assistance; 3) the profession’s expertise allows its practitioners extensive autonomy in matters pertaining to it; 4) professionals accept that they have special obligations.
British ethicist Paul Rowbottom suggested six characteristics for the recognition of a profession: 1) a body of knowledge, 2) which has practical applications (technology); 3) "exclusive competence;" that is, the knowledge and technology are too complicated to be employed by the laity; 4) the profession must develop and transmit its own knowledge; 5) practitioners accept a service ethic; 6) the profession controls the entry of its members.
California dentist Alvin Rosenblum similarly defined a profession with five points: 1) education beyond the usual level, to continue for life; 2) self regulation; 3) technical competence for which one is held morally responsible; 4) self improvement; 5) service to humanity.
It has been said that professionals are people who can do their job when they don't feel like it. In fact, as Robert Kirby put it, the mark of a true professional is giving more than you get. As long as dentists put that understanding in practice, we will be providers in the best sense.
From Inscriptions, Journal of the Arizona Dental Association, 14(12):5, June 2000. Dr. Eric Curtis is author of Hand to Mouth: Essays on the Art of Dentistry, Quintessence, 2002.