Tag Archives: professionalism

more on professionalism: insurance, education and organizations

i’d like to follow up on evan’s guest post yesterday, entitled, why professionalism is of the devil. evan blogs at wellbeing and health – this is a topic he’s passionate about.

evan says that his problem lies with professionalism, not with professionals. they lie with professional organizations and all that comes with them.

i think evan raises a number of interesting points. i’m going to address three here.

professional organizations

professional organizations are made up of professionals. granted, the professionals who actively participate in professional organizations are usually just a very small fraction of the professionals they represent. but then this is really similar to democracy, isn’t it? there are only a few people who bother to get involved. and yes, a good portion of those who do get involved are power hungry, busybodies or control freaks.

but not all of them are. many of the people who get involved seriously care about the issue, and seriously want to make something really good happen for the constituency. almost always, there are not nearly enough people to make it all happen, and things turn out to be less-than-ideal.

insurance

insurance is a double-edged sword and i keep dancing around it all the time. we’re talking about risk here. here are the categories i see:

mitigating loss and suffering through making prudent provisions for adverse events

  • that do not happen often but do happen once in a while (car insurance and health insurance are good examples) and which carry small to very large costs
  • that happen very rarely but when they do occur they carry enormous costs (e.g. malpractice suits)
  • that happen very rarely and when they do, they carry small to very large costs (e.g. many forms of home insurance)

of course insurance is much more complicated (just think of all the mind-boggling small print that excludes a myriad of circumstances) but i think the above can be a good first guideline.

i think the operative word above is “prudent”. going without professional insurance that is the equivalent of the first instance is silly. but reaching for insurance in all categories will often hamper the delivery of good service to the patient – simply because often, for all intents and purposes, the client has ceased to be the patient. the client is now the insurance company/companies. we hear a lot of horror stories about that from the U.S. i’m glad i live in canada, where it’s a bit better.

continuing education

evan says, “professions prevent the learning of practitioners.”

i’m not sure about that. all the professional organizations i know require continuing education. this is a topic i’ve often thought about, to a large degree, i think, because of my work with people with chronic conditions (e.g. chronic pain, or depression). medical doctors tend to be quite ill-informed about these health issues. the question, however, is how to help them learn more about it. doctors are helplessly overworked (one could say that being a doctor is in itself a chronic health condition). like anyone else, they want to have leeway in terms of what they do for continuing education. the things they CAN learn more about are endless. so they’re going to pick their battles. and if one of the continuing education courses comes sweetened by a conference – literally sweetened, with rum and cakes – who can blame them for going for it?

what i would like to see there is more patient groups that aggressively go out and find ways for professionals to get continuing education.

is that a pipe dream?

why professionalism (not professionals) is of the devil

this is a guest post by evan hadkins. his blog is wellbeing and health where he writes about all aspects of health (physical, emotional, mental, spiritual and social) with a bias to psychological health and a focus on practical things to do that can make a real difference. he also has a membership course, living authentically, that begins on monday 13th of october – an eight week course to finding satisfaction through authenticity.

this is probably a bit of a contrarian view to the prevailing one in the healing arts so i want to make two things clear at the outset:

1. i’m not talking about individuals. those i know who practise the healing arts are well motivated and competent. i am not attacking any individual, i am talking about a system of organisation.
2. i’m talking about professionalism as it exists. some people regard “professionalism” as meaning practise that is both ethical and skilful. i naturally have no objection to “professionalism” understood in this way.

what do i mean by “professionalism”?

it is a system of organising practitioners (my interest is in the practitioners of healing arts) that is characterised by conferences, insurance policies, meetings, codes of conduct and associations.

why is “professionalism” of the devil?
1. the devil lies. the prestige of the professions, rather than those who just ‘hold down a jobs’, is meant to be due to the profession being dedicated to the care of the client first.

in fact professional associations are dedicated to looking after their members first. (this is not a bad thing – it is just a bad thing to lie about it and say that they are dedicated to clients’ needs first.)

if the professions were dedicated to clients’ needs first we would see the healing arts primarily given for free. we would see practitioners on the same incomes as those their clients.

anyone who has brought a complaint against a member of an association will have experienced the hoops that need to be jumped through. it is by no means the rule that the person in the first instance is supported – sometimes they are not believed.

2. the devil doesn’t heal but destroys. the processes used when a complaint is brought are usually legalistic and often enough abusive. for these kinds of processes to be used in the healing arts is scandalous. it is inconsistent with the mission to heal.

3. professions prevent the learning of practitioners. members of professional association are constrained by rules. it is usually necessary to abide by these rules in order to obtain professional practise insurance.

these rules are based on past experience, sometimes called ‘evidence based’. for an art to progress it needs to learn. but these codes are not devoted to the encouragement of innovation. they are instead devoted to encourage routines. (what else could be codified?) this is hardly the way to put first the needs of individuals.

when a professional is asked to defend their practise (say in a court of law) the defense is mounted in terms of consistency with others and the prevailing rules. this clearly is not a learning process.

4. which brings us to all those conferences.
if they are so worthwhile and necessary why are professional development points necessary? how many professionals have had their practise revolutionised this year by what they learnt at a conference? ok then, five years? ten? during their working life?

it is ok for people to get together with those in the same profession. gossip and so on can oil the wheels or interaction. it’s great to get together with those with common interests. but the idea that this is the way to improve the practise of healing is an altogether different claim.

if the professionals are so dedicated to learning and the information so valuable then their should be no reason for compelling people to attend – by requiring people to earn professional development points.

which was the last professional conference in the healing arts that was a genuinely healing experience for those who attended? they may exist, they are very far from being the general rule.

neither are these conferences particularly good educational practise. the gluteus maximus is not the primary organ of learning. sitting around listening to someone read a paper is not the best way to learn. that the healing arts, which want to present themselves as wholistic, adopt this approach is so ludicrous that it defies belief.

professionalism is of the devil because:

  • it puts the needs of the professionals before those of the clients’ while claiming to put the clients’ needs first.
  • the structures and processes of professionalism impede learning and stop improvement in healing.

my hope in writing this post is to encourage thinking about better ways to organise healing and healers. contrary views are very welcome. looking forward to seeing your comments discussing ways forward.