In managing pain and anxiety, the medical professionals who work in this culture often organize themselves around the need to control, at all costs, the experience of death by deferring it as long as possible for themselves and their patients. Pain is to be tolerated. Death is to be resisted and overcome no matter what the cost. Similarly, for professionals in other fields, there is often a fundamental (existential) outcome to be avoided at all costs—whether it be the collapse of a building they designed, the failure of an audit, or the inability of students to grasp a new interpretation (“nothing but dumb looks!”).
Professional practitioners have invented models and organizational structures and put systems in place to prevent these existential failures. These structures and systems are, by necessity, focused on the client/patient. Unlike in some cultures, the person or group being served must come first in the professional culture. Professional codes of ethics and conduct will inevitably emphasize this point.
People from the professional culture have theories about organizing for maximum effectiveness that involve putting their client/patient first, which ultimately has to do with preventing or curtailing any existential failure. The client/patient comes first because it is through this person being served that professional providers receive repeated reassurance and support for their good job.
This, paradoxically, becomes the central ingredient in the provider’s sense of life purpose. Members of the professional culture look for strategies for organizational change that promise to increase their control over and to have the opportunity to influence the quality of service they provide. All of this leads to a dominant value in the professional culture. This is the value inherent in Professional Autonomy.
The professional culture has been dominant in many societies over the past 100 years. However, it is now being attacked from all sides and must share power with other cultures in contemporary organizations—especially the Managerial Culture (Bergquist and Brock, 2008; Bergquist, Guest and Rooney, 2004; Bergquist and Pawlak,2007). The professional culture finds and takes its meaning primarily from its members’ professional memberships and associations.
Members of this culture value technical expertise and specialized technical language. They are fully committed to preserving professional autonomy and have established quasi-political governance processes to ensure this autonomy. These processes have enabled professionals in many fields over the past hundred years to strongly influence or even dictate the policies, procedures and missions of institutions in the society where they operate. Members of this culture hold assumptions about the dominance of rationality and technically based procedures in institutions where and with which they operate.
The professional culture also highly values competency. This emphasis helps reduce the anxiety of providers and clients/patients. This emphasis, unfortunately, also tends to perpetuate the myth of professional infallibility and can block public access to the secrets of the inner temple of a profession. Members of the professional culture value hierarchy and believe that a clear and stable hierarchy can effectively reduce the anxiety of both providers and clients/patients. This does not mean that the professional culture values bureaucracy—a hallmark of the managerial culture. Members of the professional culture instead value clarity regarding whom is in charge in any given instance. This emphasis on hierarchy can, in turn, lead to major status differences among service providers.
