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Professionalisation and Activism (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 (university-based) training programmes proliferated during this period as practice became more specialised. This process continued into the twentieth century, when new areas of expertise emerged.

However, medical expertise and the professional status of medical practitioners have equally been the subject of critique and challenge, from the state and from patients – particularly marginalised groups or those with long-term chronic health conditions – who posit a need to understand more about their own bodies from an experiential standpoint.

This session will look at these developments predominantly in the British context and 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. Finally, we will explore how ‘professionalisation’ should be integrated into the historiography of medicine?

Seminar Questions:

  • How has ‘professionalisation’ changed the nature of medical practice?
  • Who gets to count as a ‘professional’ and who is excluded?
  • What role have gender, race and class played in the creation of medical professions?
  • How helpful is ‘professionalisation’ to the study of medical history (or how helpful has it been) and what are its limitations?
  • Are ‘professions’ opposed to ‘activists’ or ‘patients’? Is it possible to write a history of medical professionalisation that is also a history of activists and patients?

Required 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

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

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

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

Then, please choose one of the following from this recent edited collection (available as an e-book). You are welcome to divide up responsibility amongst yourselves to ensure more comprehensive coverage:

Burkhart Brückner, ‘Lunatics’ rights activism in Britain and the German Empire, 1870-1920’, in Anne Hanley and Jessica Meyer (eds), Patient Voices in Britain, 1840-1948 (Manchester, 2021), pp. 91-124

Coreen McGuire, Jaipreet Virdi and Jenny Hutton, ‘Respiratory technologies and the co-production of breathing in the twentieth century’, in idem, pp. 183-222

Georgia McWhinney, ‘The patient’s new clothes: British soldiers as complementary practitioners in the First World War’, in idem, pp. 223-251


The ‘Classics’:

As you can tell from their publication dates, these are slightly older works, which have proved influential in thinking about professionalisation. It would be helpful for discussion to sample and dip into some of them. How do their authors use and frame ‘professionalisation’? Since many of these are only available as hard-copy books in the Library you might (again) like to divide up reading responsibility between yourselves ahead of the seminar?

Eliot Friedson, Professional Dominance: the social structure of medical care (New York: Aldine Publishing Company, 1970)

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

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


Further Readings:

Andrew Burchell and Mathew Thomson, ‘Composing well-being: mental health and the Mass Observation Project in twentieth-century Britain’, Social History of Medicine, 35 (2022), pp. 444-472

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.

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

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.

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

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 Carsten Timmermann, ‘Clinical Trials and the Reorganization of Medical Research in post-Second World War Britain’, Medical History, 52 (2008): 493-510. 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