Before the Professional Project: Success and Failure at Creating an Organizational Representative for English Doctors
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Theories of the professions do not sufficiently explain how individuals with different and often ill-defined interests can organize themselves into a group coherent enough to undertake a “professional project.” I suggest that concepts from institutional and organizational theory can help fill this gap and apply such concepts to one of the first professional projects, that of English doctors. In the early nineteenth century, two groups sought to become the organizational representative of the incipient profession. The first rapidly organized a sizeable fraction of practitioners and achieved some legislative success, but could not transform its early accomplishments into a position as the doctors' representative. The second had only moderate impact in its early years and was dismissed as politically irrelevant, but eventually united the profession and continues to this day as the British Medical Association. The professions literature, most of which is pitched at a broader level of analysis, does not provide theoretical tools to explain these divergent outcomes. I argue that they can be accounted for by analyzing English medicine as an institutional field. The groups' different structural locations within the field affected their trajectories, and a novel organizational model borrowed from an adjacent field helped the latter group keep doctors mobilized and achieve legitimacy. As a result, an unlikely–looking group of outsiders with limited resources was eventually able to lead a successful professional project, while an initially promising group fell by the wayside.
KeywordsRoyal College General Medical Council Organizational Representative AASA Paper English Doctor
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