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Connecting Status and Professional Learning: An Analysis of Midwives Career Using the Place© Model

Reimagining the Place of the Professional, before It Is too Late: Five Dystopias and an Oxymoron?

School of Education, Ulster University, Cromore Rd, Coleraine, Northern Ireland BT52 1SA, UK
Educ. Sci. 2019, 9(4), 272;
Received: 21 August 2019 / Revised: 8 October 2019 / Accepted: 10 October 2019 / Published: 14 November 2019
(This article belongs to the Special Issue Education for the Professions in Times of Change )


The trustworthiness and expertise of professionals is much in demand even while they are derided as members of slippery, credentialized and self-serving elites. Eliot Friedson’s three ‘logics’ provide a contextual lens for this deconstruction of ‘professional’ and are updated by adding Artificial Intelligence (AI) as putative fourth logic to provide a contextual background—so, Markets, Bureaucracy and AI are seen as alternatives to and influences on professionalism. This context suggests that it may already be too late to save ‘professionals’, but them paper confronts a significant conceptual deficit by using a second interdisciplinary lens, Clarke’s Place Model, to critically deconstruct the ‘place’ of professionals to reimagine a commodious and accessible conceptualization, consisting of five dystopias and a potentially potent oxymoron—inclusive professional. The Place Model is presented as an example of a Geographical Imagination (Massey), combining two conceptions of ‘place’: place as esteem and place as a changing position on the expanding horizons of a career-long growth of expertise. This novel conceptualization is then used to examine the dystopias and potential ideals of ‘professional’.
Keywords: professions; Place Model; unprofessional; professionalized; inclusive professional professions; Place Model; unprofessional; professionalized; inclusive professional

1. Introduction

This paper confronts a significant conceptual deficit by using a novel interdisciplinary lens, Clarke’s Place Model [1,2], to deconstruct critically the term ‘professional’ and to reimagine a commodious and accessible conceptualization, consisting of five dystopias and a potentially potent oxymoron—inclusive professional. Bourdieu’s [3] argument that the term ‘professional’ should not even be used flew in the face of a reality in which professionals persisted and proliferated in (mostly) ingenuous defiance of one of the most eminent French public intellectuals of the age. He saw professional as a folk concept which has been smuggled into scientific language (p. 342, [4]). Today, mapping a critical but polysemous understanding of professional is a matter of even greater urgency, in the light of enormously complex global challenges, the growing distrust of professionals which is a significant trend in a rising tide of populist political discourse, and the mounting concern that most of the traditional professions will be dismantled and replaced by a mixture of Artificial Intelligence (AI) and less expert, more flexible people to quote Susskind and Susskind [5]. It may already be too late to save a chameleon term which is widely used in contexts of ambition, admiration and entreaty but is also viewed as inherently slippery, imbued with ambitions for high status and exclusivity, credentialism and over-regulation, and, as Gatenby observes, as a product of self-serving elitism [6].
The word professional attracts many rhetorical ambiguities not least because it is often defined by its most shiny aspects and polished ideals. At the core of the ideal professional is sheer, often unsung, complex work—underpinned by a combination of two key attributes: expertise and trustworthiness. Professionals deserve to be believed because, unlike the laity, they are, in their respective fields, better at finding the truth. However, O’Neill notes that they will be trusted only to the extent that they are not deceitful and are trustworthy [7]. Without this, a profession becomes what wrestling is to sport, a monetized and fabricated performance, which could be readily substituted by robotized AI. Meanwhile, Eliot Freidson’s [8] alternatives to professionalism, his other two logics, bureaucracy and the market, are in the ascendancy, shaping both the professions and individual professionals. AI is posited as a further contextual logic here—one whose protean development looks set to encroach further on the place of professionals in ways which seem increasingly less than transparent or predictable. And yet, none of these alternative logics is sufficient for what we still want or need or demand from professionals—as, for example, in Bangladesh where Alhamdan, Al-Saadi, Baroutsis, Du Plessis, Hamid and Honan (p. 499, [9]) state, an ideal ‘superhuman’ teacher is ‘neutral, kind hearted, friendly, knowledgeable, brave, sincere, dynamic, cordial, selfless, a motivator of children, attentive to students and unbiased, sincere, punctual and respectful’. By contrast, George Bernard Shaw decried all professions as merely conspiracies against the laity [10]. Some distrust of professionals has persisted and a century later is being stoked by populist jingoism, although the term ‘laity’ is more rarely used in this context today. Nonetheless, it may be that we, the laities, are asking too much, even while decrying elitism and expense; offering the never-sufficient professional up to the tongue lashing of the demagogue, yet always wanting more from the teacher, the nurse, the academic, the doctor, the lawyer, the engineer, the social worker. It may be that we, the professionals, are asking too much, wanting to maintain an elite, inflexible and expensive place of esteem even while hoarding knowledge, excluding many talented people and hiding the fallibilities which can be exploited by the unscrupulous. We need a better map of this extensive but infinitely contestable place: the place of professionals—this paper aims to provide such a map.
The Place Model will be used to reimagine this important borderland between the world as it is and the world as it could be. Place was a salient idea for the Nobel Laureate, Seamus Heaney, in The Herbal, Human Chain. Imagination allowed him to capture and share the landscapes of his life in one of his final poems … “I had my existence. I was there. Me in place and the place in me” [11]. The Place Model maps a similarly embodied view of place, by speculatively redeploying Doreen Massey’s notion of Geographical Imagination [12] in which we can each map our own position, in our mind’s eye, in respect of two key dimensions: status and location. For the Chinese-American humanistic Geographer, Yi-Fu Tuan, these two senses of place are observably interrelated—for example, the status-place of a wealthy person is reflected in where he/she lives, the location of his/her table in a restaurant, and his/her position at the board table [13]. The Place Model, likewise, juxtaposes two senses of place to achieve a timely, a priori examination of the place of professionals:
  • place in the humanistic geography tradition as a process of expertise building—location in relation to the expanding horizon of a cumulative, career-long learning journey—and also,
  • place, in the sociological sense of esteem.
Combining these two senses of place provides an interdisciplinary framework for imaginative discourse which can yield a wide-ranging and challenging set of perspectives on professionals. Clarke [14] admits that whilst “the Model is reductionist in nature (like many models), the Place Model presents a usefully uncluttered landscape which is mapped in a way that is intentionally schematic rather than mathematical in nature (although it does look like a graph), a heuristic rather than a positivist equation”. Here it is, once again, proffered as an interdisciplinary thinking tool for two key user groups: student professionals and their tutors. In preparing their students for their professional futures, tutors may invite them to consider critically their future learning journeys and status, across its terrain.
The Place Model will be used to consider and compare contemporary conceptions of professionals, and to provide an unconventional and original map, a conception which acknowledges the flaws while suggesting ideals and their limitations. The places within this landscape are strongly influenced by Freidson’s [8] other two logics, to be outlined below, together with AI, a putative additional ‘logic’, in order to set the scene, before moving on to explore and populate the Place Model itself. This essay will focus on examples drawn from health, social care and education (the third one will dominate, reflecting the author’s professional learning journey) which have arguably been most strongly affected by the ascent and increasing dominance of these alternative logics. It is possible to apply the Place Model to all professions, even to politics and sports, where the term is used in quite different ways—where ‘professional’ can be an insult while being sufficiently elastic to describe both the player and the foul play. Unpacking these exceptional cases is quite another essay, as is a linguistic analysis of profession, professional and professionalism, which are treated here as grammatical variations of the same logic.

2. Freidson’s Three Logics - and a Fourth

Freidson [8] views professionalism as a third (and superior) logic, relative to world-views governed by either the market, where consumers are in control, or bureaucracy, where managers dominate. This essay proffers AI as a fourth logic and the following sections will outline some of the main overlaps between each logic and professionalism. Having used these logics to provide a context, professionalism itself will then be the focus of the remainder of the work.

2.1. Markets

Marketization is based on selling, buying and competition; generating the profits which can enrich shareholders and can also be used to fund innovation and the production, polishing, advertising and selling of a variety of reliable products and services, including an increasing plethora of financial services in the increasingly lucrative rentier economy. Freidson drew several examples from his field [8] (medicine, in the United States), exploring, for example, how patients could no longer trust that the intervention was really for their good as opposed to lining the pockets of private doctors and the pharmaceutical industry, but acknowledging that profits could also fund the discovery, development and testing of better treatments. He may not have even imagined the new level of power or the concomitant lowering of trust, as O’Neill puts it [7], that the impact of markets on professionals’ work has helped to bring about today. These are evident in both pervasive progress and widespread disruption. For example, they appear in the development of extraordinary and transformative computing technologies, which have put powerful computers into the hands of billions of people but also in the damage wrought in the opioid crisis in the United States, as well as the mass outward migration of professionals from poorer countries to those where they can build better careers and lifestyles. Volunteers and philanthropists, driven inter alia by ideology, politics and sheer expediency, may seem benign or even altruistic, but are sometimes deployed in ways which are neither.
Giridharadas [15] describes the impact of rampant capitalism (Moneyworld) in creating a few large, rich and powerful global corporations, and in high levels of inequality (mapped vividly by Dorling [16] which mean that money can now wield a new Metapower, which can be both highly exclusive and very destructive, even while, like the doctor, seeming to do good. The apparent benevolence of large-scale philanthropy allows the super-rich to intervene in the work of professionals, as Knox and Quirk said, to ‘pay to play’ [17], despite their lack of expertise. If your education, medical, social care system is funded by such people, then professionals may feel powerless to offer criticism. This level of trust-without-challenge was once given to the most powerful professionals too, the cardinals, professors, judges and medical consultants. Even as some of these most exclusive professionals have been shown to have feet of clay, they have been replaced at the top of hierarchies of deference by the very wealthy who distinctively support only those interventions which are designed on the basis of a business model described by Giriharadas [15] as ‘win-win’. These are interventions which bring some societal benefits, but which also further enrich the benefactors, and, crucially, do nothing to disturb or rectify the iniquitous problems that they have created and which sustain their wealth and power. Even the most powerful professionals are, it seems, increasingly defenseless against Moneyworld and, in their powerlessness, can then seek to abdicate their responsibility. They can do likewise in respect of the impacts of bureaucracy too, particularly, perhaps, where this is technologized … computer says no!

2.2. Bureaucracy

In Freidson’s [8] second logic, bureaucracies have increasingly been put in place by governments and organizations wishing to enhance, assess, evaluate and monitor the work of employees and professionals, and, crucially, to manage them. Clarke [14] notes that “effective bureaucracy, at its best, can permit and attempt to ensure that general principles are predictably shared across society”. At its most technicist, this amounts to Digital Taylorism, a production efficiency methodology that breaks every action, job or task into small and clearly defined segments which can be easily analyzed and taught, named after the US industrial engineer, Frederick Winslow Taylor [18]. However, professionals have long been involved in maintaining, sharing and evaluating evidence of their work in ways which help to maintain standards and also underpin their trustworthiness in the most important aspects of their roles—exam pass-rates, infection control, death rates following surgery, numbers of children placed in foster care.
Such scrutiny, as Foucault [19] points out, can even lead to increased self-surveillance (thus the reducing costs of monitoring) and alterations of behavior to align with the dominant discourses. It is only in recent years, though, when bureaucracy has been underpinned by more pervasive metrics systems based in an increasing range of protean and accessible technologies, that vast data trails have been made available to increasing ranks of managers and also to the public, providing data which can make it very clear whether trust is well founded or not. The latter is often more newsworthy and certainly has provided evidence for that most loaded of insults, “the enemies of the people”. While the sharing of datasets can assist in fruitful, interdisciplinary collaboration, it can also evidence more negative collusion among the professions and can be publicly used to portray professionals as a mere cabal of self-interested conspirators. If professionals’ esteem depends on expertise and trustworthiness, and the records show that these are individually or collectively dubious, then their esteem lies in very public disarray.
Bureaucratic accountability has also been developed to monitor and curtail the worst excesses of capitalism but is often too ineffectual and/or too late in these contexts. In addition, professionals playing by morally based rules are often no match for profit driven businesses. Nonetheless, a whole new invasive and pervasive cadre of inspectors has developed, and the laity have become engaged with online rating mechanisms and wearable technologies, so that some days it can feel that, at any one time one, half of the world’s population is assessing, evaluating, inspecting or rating the other half. The outcomes of such judgements are increasingly made public in league tables which allow users to appraise services and to publicly award prizes which serve both as rewards and advertising opportunities.
In an effort to improve, equalize and sustain standards the most measurable features become the most important, most lionized. The more complex, nuanced, immeasurable realities are less amenable to presentation in league tables or in sound bites and headlines, and are brought to bear much less frequently in such tick boxing evaluations of professionals. Instead, more convenient proxies are used and may be made so overly complex that league tables may be used to confuse consumers and even to subvert their assessments, as in the case of university course directors who tell their students that it would be in their own best interests to rate their courses highly—after all, who wants to be a graduate of a poorly rated course? It is hardly surprising then that professionals seek to avoid and undermine the scrutiny of this ‘new managerialism’. Such subversion, bolstered by the marketization of education for example, by viewing students as consumers, is all too obvious in a rise in pupil exclusions or ‘off-rolling’ from schools prior to inspections or public exams and in pervasive grade inflation in both public exams and university degree classifications. This leads to a spiral of further mistrust, to ever more monitoring, and to the apparent compliance and fabrication of evidence at both institutional and individual levels. In the former, as Clarke [14] points out, we might “witness the proportion of UK universities’ energies and resources dedicated to providing evidence for the Research Excellence Framework (REF) and Teaching Excellence Framework (TEF)—which purport to measure research and teaching, respectively, and then allocate both public funding and increasingly complex league table positions based on these”. At an individual level, professionals feel obliged to acquire shiny new skills to deal with such managerialism, as Ball says, and the concomitant terrors of performativity: “the skills of presentation and of inflation, making the most of ourselves, making a spectacle of ourselves, in response to audit, inspection and review, and for promotion” (p. 1054, [20]). The overall impact of the “tyranny of metrics” to cite Muller [21] can too often be allied to reductionist training, rather than to critical and complex education of professionals, and can make them feel that they are being trained, commodified and deployed as the AI which seems increasingly likely to replace and/or monitor so many of them.

2.3. Artificial Intelligence: A Fourth Logic?

The English Oxford Living Dictionary gives this definition of AI: the theory and development of computer systems able to perform tasks normally requiring human intelligence. Clarke [14] admits “that It is debatable whether AI continues a separate fourth logic, after all AI is being designed and developed in the context of the other logics” Nonetheless she argues that “it is increasingly becoming evident that AI can do more than simply replace and replicate existing roles - it is becoming ever clearer that it can behave in ways which are not fully amenable to human comprehension, ethics and control and it is this new phenomenon that means that it is arguably be best understood as a fourth logic, which will have huge impacts on the work of those professionals which it does not fully replace”.
Debates rage across the globe as to whether professionals could or should be replaced by robots and are likely to increase although no one really knows how things will turn out in respect of the erosion, augmentation or replacement of professionals. Conversely, the Susskinds [5] argue that the traditional professions will be dismantled leaving most (but not all) professionals to be replaced by high performing AI (and also by less expert people). Frey and Osborne’s seminal Oxford Martin School study [22] showed that about 47% of US employment is at risk of computerization. The study evidenced strong negative relationships between an occupation’s probability of computerization, and both wages and educational attainment. When robots are controlled by AI, those jobs most at risk include some of the more technicist professions, including those with high levels of analytical accuracy. In the health sector, these already include those who work on the painstaking analysis of diagnostic images such as X-rays, ultrasound scans and biopsy sections. However, in the longer term, the work of even the loftiest of the traditional professions may be replaceable by AI-controlled robots. The surgeon’s expertise and trustworthiness will increasingly be questioned when compared to a robot with the steadiest, most untiring and hygienic hands, informed by a less expensive and more extensive AI expertise which has been synthesized from a truly encyclopedic and dynamic knowledge of every case, everywhere. However, the value of such syntheses is already being questioned, not least because the machine learning algorithms can create models based on huge data sets which even their creators do not understand. In Katwala’s opinion, they are, in effect, a black box and can make life-changing decisions in the dark [23]. By contrast, Aoun [24] offers a promising educational solution to preparing humans to confront the rapidly evolving challenges of AI transparency in a novel, interdisciplinary model of learning, termed Humanics, which is already on the curriculum of Northwestern University. The course “enables learners to understand the highly technological world around them and that simultaneously allows them to transcend it by nurturing the mental and intellectual qualities that are unique to humans—namely, their capacity for creativity and mental flexibility” [24]. In addition, the capacity to empathize with and care for others is a key human faculty which is a surprising omission in Aoun’s Humanics [24], an omission which may be seen to reflect the fact that much of social care is not, as yet, fully researched and developed—not fully professionalized, even though it is the vulnerable who are most in need of trustworthy experts to understand, to advocate and to care for them. Working with AI in many professional contexts, the key question is ‘who takes the key decisions?’. The International Labour Organisation’s recent report suggests a “‘human-in-command’ approach to artificial intelligence that ensures that the final decisions affecting work are taken by human beings, not algorithms” (p. 43, [25]).

3. Components of the Place Model

The speech bubble below the heading of Place Model (Figure 1 below) is significant because it links professionals to their respective laities by asking the question: Who is my professional today? Clarke [14] argues that The Model provides a usefully challenging range of answers based on comparing the two conceptions of place noted above by Massey as a Geographical Imagination” [12].
The horizontal ‘axis’ is based upon building expertise across one’s career. On the diagram (Figure 1) this axis starts where a ‘new’ professional takes up their first job, but one might imagine that, putatively, on the most extreme left (well off the edge of the diagram) is the position of an egocentric baby, an extreme example of an incipient learner in its utterly Piagetian, “egocentric” [26] world view. To the extreme right is the end of an expansive growth of expertise across a career, or series of careers. Clarke [14] points out that “this axis is not about terrestrial space—professional practice most often transpires locally and has local impacts, but the internet means that learning can readily become much more far wide-reaching in both depth and breadth. In addition, the axis is not a timeline, not a history, and it is not a matter of passive survival for 30–40 years, gathering up a few tips and tricks about good practice on the way. Rather, the learning process is conceived as an expanding professional place”, using Tuan’s [13] clear formula: “Place = Space + Meaning”. The horizontal axis can be an extensive, complex and intricately featured place, built through cumulatively accreting processes of professional learning, an expanding horizon of Massey’s “outwardlookingness” [12]. As for Fullan argues [27], “learning is the work”. Clarke [14] argues that “This place may be conceived on either personal or profession-wide scales—an individual’s career or the systemic capacities for learning within a particular context, drawing on, and contributing to, a critical understanding of the best of what is known though the consumption of and/or the creation of relevant research”, with “particularly significant resonance with the early twenty-first century debates about professional status and regulation and marketization”. On the one hand, there are those who “promote a narrowly conceived technicist training approach which are linked to greater deregulation, flexibility and privatization (on the left-hand side of the axis), versus, on the other hand, the expansive professional education, predominantly within the master’s-level courses within college and university systems across the globe” [14]. Clarke [14] recognizes that “a key limitation of the Model is that the straight line of this axis cannot convey the ways in which careers are becoming more varied and more fragmented” and that “Imagination is needed here to conjure the cumulative, career-long learning journey which the increasingly dynamic nature of work demands—is there an inherent incompatibility between these demands, and the deep expertise and constant trustworthiness which are essential to professions?”
On the vertical axis, however, professionals often have much less agency as this depends on the constraints of public perceptions of esteem. The intersection of the status and learning axes alloows the creation of four quadrants which have been labelled as proto-professionals, precarious professionals, the de-professionalized and the professional. A fifth, equally important, element lies outside the axes, where the answer to the question ‘Who is my professional today?’ is ‘No one’.

4. ‘Populating’ the Place Model

Each of these components can be examined by ‘populating’ Model using the classroom thinking skills technique, Leat’s Living Graphs [28], to place a range of potential exemplars. The examples also illustrate how the other three logics have a bearing on professions. Using these examples, the following sections provide a tour of the Place Model. The tour begins by initiating the reader into the axis of the model, starting with the top left corner, the ‘proto-professionals’ before making a detour to the off-axis ‘no professional’ component and then moving anticlockwise around each of the three remaining in-axis quadrants of the model, culminating in the ‘professionals’ quadrant. In designing the Model, it has become evident that these components are neither positive nor neutral, that they are mostly dystopian, but, importantly, that there is still, perhaps, a positive place, perhaps even a utopian place for the trustworthy expert.

4.1. Proto-Professionals

The term proto-professionals has been coined here to indicate that this quadrant is often home to professionals at the earliest stages of their careers, for example newly qualified graduates of university courses which are approved by professional bodies. In the present century, these early entrants have been joined by those recruited via less regulated conceptions of professional preparation. This approach has been developed in respect of governments’ attempts to create ‘fast track’ routes for graduates of any discipline, such as Teach First and Step Up to Social Work in the UK, welcoming these entrants as innovators, often in times of personnel shortages, and adjusting (lowering) the required entry standards and competences to ease their way. In the US and in England, for example, graduates may enter the teaching profession via non-university routes to work, often as Zeichner’s short-term technician teachers, of other people’s children [29], supported by the view that teaching does not require highly specialized knowledge and skills [30]. This change in locus of teacher education from the universities to schools has been coupled with the development of more rigidly defined school curricula which may be formulaically ‘delivered’ in a lower tier education system by what Pring calls ‘deliverologists’ [31]. Giroux contrasts this with the value of an informed and critical professionalism, asserting that there is a danger of teachers “erasing themselves in an uncritical reproduction of received wisdom” (p. 20, [32]). An even more dystopian view sees the prescribed competences of technicist professionals being, in future, effortlessly ‘delivered’, not by humans, but by AI-controlled robots that continuously learning and do not ever tire – although electronic components may break or become infected with viruses.
Clarke [14] describes “the most egregious example of ‘training’, as opposed to ‘education’, is perhaps those teachers who are being trained to carry and use concealed weapons in US schools” Alternatively she suggests teachers might be educated (as opposed to trained) “instead seek to combat the systems which produce inequality, poverty and powerlessness for their pupils and hinder their chances of accessing the most elite professions” [14]. In this context she also mentions “teachers who subvert bureaucracy for their students by giving undue help with coursework/exams (see ‘unprofessionals’) might be seen as a more extreme case of this—in this case, relying on subverting bureaucracy”. Finally she notes, “the proto-professional quadrant may thus be viewed as either an early transit point for some professionals, or as the career-long settlement for others, less ‘well-travelled’ on their learning journey, who remain here because they see this as a comfortable and unchallenging home-for-life, perhaps as a local hero but with few connections and challenges beyond the local”.

4.2. No Place for Professional Nobodies

This component, where the answer to the question, ‘Who is my professional today?’ is ‘No one’, lies outside the axes of the Model. It is, however, indispensable to understanding the place of professionals not least because it poses an increasingly important, existential question for the professions: are professionals a necessity or a luxury, or are they replaceable by either para-professionals or by the ubiquitous, ever-learning potential of AI? For the purposes of this essay, only those who are ‘qualified’ professionals are deemed to be professionals. This point is both fundamental and highly contested, for it is clear that for many professions there may not be national, never mind international, agreement as to the requisite qualifications. This issue presents a significant lacuna not least because it has been the gap though which marketization has sought to break the mold of professions via the increasing deregulation which is mostly occurring in the world’s wealthiest nations. In the poorest places, meanwhile, many millions of people have no access to professionals at all.
This part of the Model resonates with the arguments of those who assert that mandatory qualifications are redolent of credentialism, are inflexible and ultimately superfluous. The growing impact of marketization in recent years has led to a growth of a second tier of para-professional roles; requiring fewer qualifications, greater flexibility and lower costs; temporary jobs attracting lower salaries but increasingly fulfilling some of the roles which were hitherto the responsibility of qualified, permanent professionals. Such jobs are attractive to applicants because the entry tariffs are not as high as those for professions while the role may attract at least some of the esteem of the professions, as the job titles imply: Associate Physician and Teaching Assistant. In addition, there has been an increase in numbers and an extension of the roles of volunteers in public sector roles. In the UK, this has been particularly notable in public libraries where the negative impacts on the erosion of expertise, care of state-funded resources and the quality of service (particularly in poorer areas where long-term volunteers can be harder to recruit) are becoming more evident, as pointed out by the Scottish Libraries and Inflation Council [33]. Busy professionals may be all too happy to shed some of their more mundane responsibilities to these new minions. The minions, however, may find that they have, for now, undertaken the clearly defined, repetitive types of job roles which are most replaceable by AI. From the perspective of the laity, para-professionals, volunteers and AI may improve access to some services and may even lead to innovation and personalization, but they can eventually create two-tier systems, with the poorest able only to access the services of the least expert and least trustworthy, while the most expert and most trustworthy in any field are available only to the wealthy—exclusive professionals (see below).
UNESCO (the United Nations, Educational Scientific and Cultural Organization) reported on the enormous global disparities in the nature of schools and schooling which mean that 57 million primary school age children lack a teacher [34]. Lack of teachers has a knock-on impact on all other professions and similarly huge deficits are found in other professions. The World Health Organisation’s (WHO) report, A universal truth: No health without a workforce [35], estimated that the world will be short of 12.9 million health-care workers by 2035; today, that figure already stands at 7.2 million.

4.3. Precarious Professionals

The next section moves back within the axes of the Place Model, to the quadrant occupied by the most ‘precarious professionals’ (akin to Standing’s precariat) [36] who have low esteem, low levels of expertise and/or trustworthiness, and short career spans. This quadrant is home to disparate types including those who might be described as ‘unprofessional’), and those who are unlikely to remain in the profession, the ‘transitory’. Both occupy precarious positions and both frequently reach the headlines—for very different reasons.
Clarke [14] notes how The Place Model’s unprofessionals pose some key questions for professional educators to ask their students about why and how and by whom they might be registered, access checked and ‘struck off’. Despite these (often inadequate) checks, there are many and varied instances of unprofessional behavior right across the globe, sometimes with fatal consequences. They severely dent the credibility of professionals across a wide range of fields, who may be seen as culpable for the catastrophes while being exclusively protected from the consequences. Acting at their most eponymous, professional bodies often profess codes of accountability, sometimes even encapsulated in professional oaths of conduct, based on the values and competences of their profession, against which such cases are judged. Many of these are locally designed versions of internationally agreed codes such as the Declaration of Geneva for the medical professions [37]. However, at the heart of these codes there is an increasingly paradoxical lack of candor: despite the increasingly pervasive and distorting effects of the markets, and of performativity measures, none of these codes declare that their profession is ambitious to make as much money as possible, or to subvert bureaucracy and fabricate evidence of competence and achievements, for example. Newly graduated professionals declaring their oaths may sound heartwarmingly virtuous, and no doubt many are genuinely invested in these statements, at the time, but the realities of human frailties and the influence of a marketized and bureaucratized world may soon override such aspirations to virtue. Squaring the circle of duty and ethics is still most glaringly illustrated in the long-standing issues of doctors who assist with carrying out capital punishments. In more recent years, the challenges of ensuring morality within AI are increasing and are, in Katwala’s words, as yet poorly understood [23].
The other exemplar occupants of this quadrant are the low status, poorly educated professionals for whom job security remains a persistent and stressful problem, where professionals are often badly paid, inadequately supported, and held in such low regard that many are forced to consider other career options. The casualization of contracts is widespread, not least in the academic sector where fee-paying students expect that they are buying access to established rather than ad hoc ‘expertise’. Many of today’s academics are malleable components of flexible labor markets. Many of their predecessors had tenure.

4.4. The De-Professionalized

In creating the Place Model, this quadrant seemed the most interesting and challenging—if it were on an old mariners’ map it might be even be labelled ‘here be dragons’—home to more established professionals who have completed a significant part of their professional learning journey, but with a relative deficit of status.
This quadrant is the locus of at least three contrasting sets of examples: the cynics whose sarcastic words and attitudes can discourage professionals and laity alike, those senior professionals who have been consigned to this place by denigration, including those cast aside following ‘one mistake’, and migrant/refugee professionals who find themselves deemed ‘unqualified’ and unemployable in their destination country.
Members of the first group might be seen, at their worst, to have repositioned themselves within the Place Model. Cynicism can be much simpler than more open-minded skepticism—turning one’s back in vitriolic despair in response to the failed inspection, rather than raising a critical eyebrow and fighting back. McDermott’s paper in this special issue discusses this matter. The senior social workers who worked to try to protect Baby P in the UK are in this quadrant too, but not for reasons of cynicism. When the baby died, the head of Children’s Services at Haringey was ‘named and shamed’ by a senior minister in the House of Commons and removed from post [38]. When things go wrong, when mistakes are made, it is often the most senior members of professions who end up being held accountable, sometimes only within the privacy of internal accountability processes, sometimes very publicly indeed with additional vilification via the rabid tabloid press. The further impacts of this case have been on social worker retention and recruitment, on increasing numbers of babies removed from their parents, and on increasing demands for social care at a time of budget cutting austerity. In healthcare contexts, consequences can readily be much more severe; just one mistake can be fatal to patients and also to careers, and the threats of ruinously expensive litigation can encourage coverups. In Northern Ireland’s health service, rules for a duty of candor are being drawn up following a major public enquiry [39] and The Doctors’ Association in the UK (DAUK) has introduced a learn not blame initiative [40]. There is a growing recognition that much medical fault finding is wasteful and deeply damaging and would be better utilized as a positive learning resource. This can be a difficult message for those harmed and requires the most persistent, eloquent and wise sponsors in order to gain public support.
The problems associated with this quadrant seem destined to expand following statutory increases in the length of teachers’ working lives in most countries. In England and Wales, Sikes (p. 27, [41]) believes that maintaining professional vigor seems destined to be a particular challenge where the “ageing of members is likely to assume increasing significance for the cultures, ethos and outcomes of schools”.
This quadrant may also be considered to be the locus of those migrant and refugee professionals who find that their previous qualifications and experience count for little in their new state, even though it may have shortages in key fields. In 2017, The United Nations High Commissioner for Refugees (UNHCR) reported that 68.5 million people around the world have been forced from home [42]. Among them are nearly 25.4 million refugees and over 80 percent of these are living in economically less developed countries. Perennial arguments around exclusive protectionism in professions versus the wage lowering potential of an influx of new professionals are played out, often soto voce, in the common-rooms and committees of professional bodies where the challenges of designing and funding appropriate Continuing Professional Development highlight the importance of delineating, maintaining and communicating the profession’s external thresholds and its internal ideals, its distinctive strengths and its singular contribution to the world.

4.5. The Professionals

Thus far, this exploration of professionals using the Place Model has largely pointed towards what an ideal professional is not, a vision of multiple dystopias which are partly the by-products of professions themselves and sometimes of the impacts of the other logics. By contrast, the Place Model frames the professionals as being progressively expert and trustworthy, highly esteemed exemplars for new entrants to the professions. This quadrant of the Model is home to a profession’s champions, standard bearers, pioneers, leaders and appraisers. Meeting one’s idols is, however, a risky business—as Flaubert [43] notes, the gold paint tends to come off on your fingers. These super-trustworthy experts are fallible humans too—which can offer the hope that becoming such a hero is, perhaps, an accessible ambition.

4.5.1. Exclusive Professionals

Dystopia is also found even in this quadrant of the Place Model, not least because some of those at the top of professions may be surrounded by boundaries of exclusivity which are patrolled by Cerberus-like personal assistants, by expensive educations which act as what Kynaston and Green call engines of privilege [44], by prohibitive fees, by cut-glass accents and expensive tailoring, or, less tangibly, by an assiduously cultivated aura of godlike inapproachability, which may appear just as insurmountable as any physical barrier. These exclusive professionals often live longer and retain exclusive power longer. Professional education tutors might ask their students to consider critically their highest ambitions: where do they want to go within this most senior quadrant of the Place Model? Seniority is one thing, but they might also be challenged to consider if they intend to serve the rich and powerful, the sophisticated and eloquent, the hygienic and sweet-smelling, while presenting a variety of barriers to others.
The growth of AI has not been deterred by these boundaries. An AI surgeon will have the capacity to assimilate and synthesize all of the case notes of every piece of surgery ever performed, as well as the most intricate details of a specific patient’s medical history, will have the steadiest and most hygienic of ‘hands’, will not tire or become distracted, and may be chosen by a patient in preference to the most eminent of human surgeons. Aggrieved litigants and eagle-eyed managers (often fearing litigation) may seek to ensure that accountability mechanisms are used to remove (professionalize) any surgeon who commits any error. Increasingly, therefore, such exclusive professionals are somewhat less unassailable than they have been to date. Increasingly surrounded, squeezed and encapsulated by the forces of markets, bureaucracy and AI, these top professionals are less likely to rise to their most crucial challenge: using their extensive expertise not to subvert the markets and bureaucracy, not to out-robot robots, but rather to out-human them in curiosity, care and creativity as inclusive professionals.

4.5.2. Inclusive Professional: Utopia or Oxymoron?

Like the exclusive professionals, this final category within the Place Model combines high levels of trustworthiness with the capacity to connect local practice and the latest global expertise. The flaw, however, perhaps the fatal flaw in the notion of inclusive professionals, is that it may be that, as Sandel [45] comments, in a market society, exclusivity is absolutely essential to professionals in cornering their market, thus making inclusive professions impossible—a utopian oxymoron. Interestingly, Thomas More’s concept of Utopia affords places for both utopias and oxymorons—in the original Greek, utopia may mean either ‘good place’ or ‘no place’ [46].
The discussion might end here, if it were not for the reality in which many professionals do, in fact, overcome this oxymoron. While inhabiting a world increasingly dominated by markets and bureaucracy, where AI is also more pervasive, less transparent and insufficient in some important human capabilities, many professionals’ expertise and trustworthiness are not for sale, not solely motivated and subverted by ticking boxes, not replaceable by AI. This essay concludes with an attempt to push open the door to a discussion of the possibilities and impossibilities of inclusive professionals.
Most importantly, the place of the inclusive professional might be seen to include the entire map of the Place Model (dystopias and all) which has been created to imagine a more commodious, polysemous understanding of professional. It might be argued that as fallible humans, all professionals have the potential to embody all/many of the components of the model, sometimes several within one day.
Inclusion begins with recruitment into the proto-professional quadrant where most people enter a profession. One hundred percent inclusion is not possible and is only viable at all with the removal of the well documented structural barriers to recruitment: wealth and social class, gender, sexual orientation and race. Realistically, however, professions are still seen as desirable, scarce resources and are thus prey to the perennial sharpening of elbows, (a seemingly incurable, if understandable malaise), starting with the parents of even the youngest school pupils, a phenomenon which is tied to marketization and which, therefore, may be impossible to prevent completely. All professions declare an interest in widening access. Only some succeed to only some extent.
By contrast, the influence of proactively inclusive professionals can be brought to bear right across the Place Model, through the professional bodies which sanction and judiciously (but not wantonly) remove the unprofessionals, in providing mentorship and supporting the learning of peers and proto-professionals, even across national borders in institutional twinning projects or individual one-to-one assistance which aims to supplement or surpass traditional aid projects in the poorest places. Welcoming professions can also reach out within their own localities by seeking to educate the laity about the unvarnished realities their roles: The Guardian’sWhat I’m really thinking’ column [47], for example, allows practitioners to share candidly the view from their side of the desk/scalpel/book/keyboard/bench. Such pragmatic outreach allows professionals to share in, navigate to (and learn in) places which supersede the constraints of markets and bureaucracy, but may (in reality) be viewed as damaging to the market-cornering potential of professions. This might be further compromized if the professional oaths of inclusive professionals were to explicitly preclude acting on the basis of individual or corporate greed and admit, for example, the reality that even the most extraordinarily talented and dedicated people make mistakes—it is how professionals learn, in response, that matters. The inclusive professional is inarguably a more ambitious outcome of what humanity is capable of than an individualistic survival-of-the-fittest based on markets and constantly monitored and managed by bureaucrats—which might be seen as a pervasive underestimation of humanity. Barack Obama, speaking to Wired Magazine [48], made an important observation about the future of professionals in the context of more widespread but never fully ubiquitous AI. He predicted that the totem pole of professional status will be upended and that the most human, caring and creative professionals, those who are often underpaid today (teachers, nurses, caregivers, and those in the arts) will, in future, be better understood and more highly esteemed for the universality of their trustworthy expertise.

5. Conclusions

Using the Place Model to reimagine a more commodious understanding of the place of professionals provides a timely and candid analysis which does not lose sight of those who most need the services of the most dependable experts. The Model delivers a useful map of the tensions which exist between the many contrasting viewpoints about who, if anyone, might still be a professional. Those entering the professions must have opportunities to cast a critical eye over their careers, to appreciate that many professionals may be (required to be) increasingly shiny, but are neither expert nor trustworthy, are vilified rather than supported by those in power, and are subject to both marketization of their services and to bureaucratic accountability and also to replacement or augmentation by AI. Likewise, the Model points to ways in which markets and bureaucracy are deforming underestimations of human potential, whist the potential of AI is as yet insufficiently understood. While the competitive markets patrolled by pervasive (and sometime well intentioned) bureaucracy may well be underestimations of the potential of humanity, perhaps inclusive professions are an overestimation. On the other hand, Bourdieu, for all his enduring esteem, has perhaps underestimated the persistent place of professionals as trustworthy experts, particularly in roles involving human qualities which continue to be in demand but cannot be straightforwardly bought, sold, measured or robotized. Such is the place of the inclusive professional, an ideal which (yet) has much to offer to the betterment of the world.


This research received no external funding.


I acknowledge the advice of Professor Marilyn Cochrane Smith around the stripped back version of the Place Model in this article.

Conflicts of Interest

The author declares no conflict of interest.


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Figure 1. The Place Model.
Figure 1. The Place Model.
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