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Professionalisation and Regulation (Andrew Burchell)

In the nineteenth century, medical practitioners in the West began to fasten their professional identity on the increasingly ‘scientific’ character of modern medicine. Medical societies, journals, and training programmes proliferated during this period as practice became more specialised. This process continued into the twentieth century, and new areas of expertise emerged in relation to the growing role of the state as a provider of medical care. This session will look at these developments predominantly in the British context, showing how relations between patients, practitioners, and the state changed from the mid-nineteenth century into the post-war period, defined by steadily increasing levels of regulation and standardisation. In examining these shifts, we will consider how the authority of biomedicine has been consolidated over time, and how not every profession within medicine has followed the same chronology or the identical course.

We will also explore some of the challenges posed to this process, both during the nineteenth and twentieth centuries, and ask how professionalisation should be integrated into the historiography of medicine.

Seminar Questions:
  1. How has ‘professionalisation’ changed the nature of medical practice?
  2. What role has the state played in the growth of professionalisation and biomedicine?
  3. In what sense has medicine become more ‘scientific’ since the nineteenth century?
  4. What role have gender, race and class played in the creation of medical professions?
  5. What have been the limitations to the process of ‘professionalisation’?
Required Readings:

Please read the following:

S.E.D. Shortt, ‘Physicians, Science, and Status: Issues in the Professionalization of Anglo-American Medicine in the Nineteenth Century’, Medical History, 27 (1983), pp. 51-68. e-journal

Jane Lewis, 'Providers, 'Consumers', the State and the Delivery of Health-care Services in Twentieth-Century Britain', in Andrew Wear, ed., Medicine in Society: Historical Essays (Cambridge, 1992), pp. 317-345. e-book

Steve Sturdy and Roger Cooter, ‘Science, Scientific Management and the Transformation of Medicine in Britain c.1870-1950’, History of Science, 36 (1998), pp. 421-466. e-journal

George Weisz, ‘The Emergence of Medical Specialization in the Nineteenth Century', Bulletin of the History of Medicine, 77 (2003), pp. 536-74. e-journal

And then pick one of these (or read both, if you have time and wish to do so):

Jois Stansfield, 'Giving voice: an oral history of speech and language therapy', International Journal of Communication Disorders, 55:3 (2020), pp. 320-331. e-journal

Grace Redhead, ‘“A British problem affecting British people”: sickle cell anaemia, medical activism and race in the National Health Service, 1975-1993’, Twentieth Century British History, 32:2 (2021), pp. 189-211. e-journal

 

Further Readings:

J. C. Burham, ‘How the Concept of Profession Evolved in the Work of Historians of Medicine,’ Bulletin of the History of Medicine,70 (1996): 1-24. e-journal

Ian A. Burney. ‘The Politics of Particularism: Medicalization and Medical Reform in Nineteenth-Century Britain,’ in Roberta E. Bivins and John V. Pickstone (eds), Medicine, Madness and Social History: Essays in Honour of Roy Porter (Basingstoke, 2007), pp. 46-57.

W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century(Cambridge, 1994).

Ann Digby, Making a Medical Living: Doctors and Patients in the English Market for Medicine, 1720-1911 (Cambridge, 1994).

Melvyn Lloyd Draper, '"Not for us the weekly dose of sulphur and brimstone!": Women, Family and Homeopathic Medicine in Early Twentieth-Century Britain', Social History of Medicine, 32 (2019), 523-43.

Angela C. Haas, 'Medical Marvels and Professional Medicine: Establishing Scientific Authority in Enlightenment France', Social History of Medicine, 33 (2020), 702-27.

Irvine Loudon, Medical Care and the General Practitioner, 1750-1850 (Oxford, 1987).

Vicky Long, '"Often there is a good deal to be done, but socially rather than medically": the psychiatric social worker as social therapist', Medical History, 55 (2011), 223-39.

Andreas-Holger Maehle, 'Beyond Professional Self-Interest: Medical Ethics and the Disciplinary Function of the General Medical Council of the United Kingdom, 1858-1914', Social History of Medicine, 33 (2020), 41-56.

Sabrina Minuzzi, '"Quick to say quack": Medical Secrets from Household to the Apothecary's Shop in Eighteenth Century Venice', Social History of Medicine, 32 (2019), 1-33.

Matthew Ramsey, Professional and Popular Medicine in France, 1770-1830: The Social World of Medical Practice (Cambridge, 2002).

Jois Stansfield, 'Reflections on being an oral history insider: subjectivity, intersubjectivity and speech therapy', Oral History, Autumn 2020, pp. 90-101

Steve Sturdy, ‘Looking for Trouble: Medical Science and Clinical Practice in the Historiography of Modern Medicine,’ Social History of Medicine, 24 (2011): 739-757.

Keir Waddington, An Introduction to the Social History of Medicine (Basingstoke, 2011), ‘Ch. 3: Practitioners and Professionalization,’ pp. 166-188.

Helen Valier and CarstenTimmermann, ‘Clinical Trials and the Reorganization of Medical Research in post-Second World War Britain’, Medical History, 52 (2008): 493-510. e-journal

George Weisz, Divide and Conquer: A Comparative History of Medical Specialization (Oxford, 2006)