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 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?


  1. Hi Isabella,

    Thanks for your response.
    1. I stressed that this was not about professionals. As your first response is about the desires of professionals (which I never questioned) it is simply beside the point. The form of an organisation constrains what is possible. My argument is that the professional form of organisation constrains healing and so is inappropriate for healers.

    2. Insurance is a big problem for me too. I’d like to see other ways of dealing with this problem (though I can’t think of any). I do think that healers should say up-front that ‘my income, lifestyle and vocation sometimes take priority over my client’s needs’. This is what taking out insurance effectively means. I just want this stated. It would generate a fruitful discussion I suspect.

    3. Continuing education. Firstly it is dreadful education. I want to know how much use it actually is: how many times has your practise been revolutionised (OK fruitfully somewhat modified) by what you learned at a conference? I am absolutely in favour of education. My problem with conferences is that they aren’t particularly educational – and so impede healing instead of improving it.

    Looking forward to seeing what others have to say (as well as any responses you may have of course).

    Evan’s last blog post..Why Professionalism (not professionals) Is Of The Devil

  2. hey evan …

    my point regarding professionals and professionalism is that the two are related.

    when i was a teenager, everyone (including me) would talk about how bad “the system” was. “the system”, like “the government” and, yes, “professional organizations” don’t all of a sudden spring up out of thin air. they are made up of people with flesh and blood.

    the upshot for me personally is that i can only complain so much about professional organizations – if i REALLY don’t like how they operate, i need to at least try and get involved. hence my talk about democracy.

    you say, “I do think that healers should say up-front that ‘my income, lifestyle and vocation sometimes take priority over my client’s needs’. This is what taking out insurance effectively means. I just want this stated.”

    i agree that discussing this openly would bring about fruitful discussions. it’s all about balance, in many ways. for example, if there was more of a recognition that a business relationship exists between most clients and healers, the sometimes excessive authority that is given to professionals might come down to a more realistic level.

    why is continuing education dreadful? or do you mean conferences are dreadful? i’d say that some conferences are awful, some are amazing. it all depends.

    i DO prefer conferences, though, that go right to the heart of practice. the best one i’ve been to so far was a multidisciplinary conference on chronic pain which was attended by persons with chronic pain as well as health practitioners.

    i don’t know how you define conference. i’ve been to a “mass workshop” (about 300 attendees) once that made a HUGE difference in my practice (with scott miller).

    what is your experience with conferences?

  3. Hi Isabella,

    re organisation. The form of an organisation doesn’t reduce to its members. There are rules and obligations involved with any form. My case is that the professional form impedes healing. As to changing them it is usually necessary to be both inside and outside what you are wishing to change – if you are inside you get co-opted if outside you have no authority. That is you would need another organisation with something the professional associations wanted (eg. members, credibility etc).

    As to education. The cognitive assumptions which academia is based on are largely insane in my view. The ‘education’ that occurs at conferences is largely in the academic mold. There are of course excellent exceptions eg. the kind of mass workshop you spoke of. My own commitment is to wholism the academic assumptions and practice are inconsistent with this. This is why I say the education is dreadful. If continuint education is so great people will turn up to it voluntarily – they won’t need to be compelled by requirements. There is an easy way to find out how worthwhile the continuing education is: stop compelling peoples’ attendance.

    My experiences of conferences is that they are a great opportunity to talk and meet. Apart from this they are like supermarkets: people passively consume information told to them by others.

    I take it that a major difference has been made to your practice once (and that this was a different kind of conference). Do we agree the others were largely a waste of time? (in terms of their professed purpose)

    I agree wholeheartedly that discussion on the business side of therapy would be great. Especially in breaking down the guru status of therapist. This would be excellent I think (beneficial to all involved).

    Evan’s last blog post..What Do You Say?

  4. no time to go into this as i’d like to but have to say that i love conferences mainly for the coffee breaks and meals in which you get a chance to meet other people – which is often where the learning comes in.

    for me professionalisation is a problem when we start acting according to those external conditions and our motivation subtly changes…

  5. “…being a doctor is in itself a chronic health condition…”

    Wonderfully astute statement !

    My experience with professionalism is that of a committed “outsider”.

    I’ve been a professional astrologer and Tarot/I Ching practitioner for over 40 years.

    I brushed up against the prevailing professional organizations many years ago and was repelled by the tenets and dogma of the members.

    Most people don’t understand or actively ignore the psychological nature of the work I do. They (and their ego-structures) would much rather be “authorities” who predict good/bad for their clients–despicable behavior !

    ~ Alex from Our Evolution

    Alexander M Zoltai’s last blog post..Path Toward Peace – Step Seven

  6. Hi Sarah,

    Thanks for your comment. Professionalism seems to me dedicated to getting people to behave in accord with those external motivators. That is why it exists.

    Thanks for your comment.

    Evan’s last blog post..What Do You Say?

  7. Hi Alex,

    Thanks for your comment. You raise the interesting issue of authority.

    I do think these organisations exist for the sake of authority. This is the other side of the argument that the members are trustworthy (because they are members). They also usually control the way that dissent and disagreement is expressed (eg. no criticism of others in the same profession).

    I think I’m pretty much an outsider too.

    Thanks for your comment, you raise very important issues.

    Evan’s last blog post..What Do You Say?

Leave a comment

Your email address will not be published. Required fields are marked *