Professions and the Public Interest: Medical Power, Altruism and Alternative Medicine

330 Pages·1994·1.76 MB·English

by  Mike Saks

Professions and the public interest
Do professions subordinate their own self-interests to the public interest?
In Professions and the Public Interest Mike Saks develops a theoretical and
methodological framework for investigating this question, which has yet to be
analysed adequately by sociologists of the professions. The framework outlined
here will be invaluable in future research on the professions.
To demonstrate how this innovative framework can be applied, Mike Saks
focuses on health care and presents a case study of the response of the medical
profession to acupuncture in nineteenth and twentieth century Britain. He
argues that the predominant climate of medical rejection of acupuncture as a
form of alternative medicine has not only run counter to the public interest, but
also been heavily influenced by professional self-interest. He considers the
implications of the case study for the accountability of the medical profession
and makes broad recommendations about the direction of future research into
this academically and politically important issue.
Professions and the Public Interest will be of interest to a wide readership,
including sociologists of the professions and health care, and teachers and
students of social policy, politics, social history and medical sociology. It will
also appeal to orthodox health care professionals and to practitioners of
alternative medicine.

Mike Saks is Professor and Head of the School of Health and Life Sciences at
De Montfort University, Leicester.
Professions and the public
interest
Medical power, altruism and
alternative medicine
Mike Saks
London and New York
First published 1995
by Routledge
11 New Fetter Lane, London EC4P 4EE
This edition published in the Taylor & Francis e-Library, 2005.
“To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection
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Simultaneously published in the USA and Canada
by Routledge
29 West 35th Street, New York, NY 10001
© 1995 Mike Saks
All rights reserved. No part of this book may be reprinted or
reproduced or utilized in any form or by any electronic,
mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information
storage or retrieval system, without permission in writing from
the publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the
British Library.
Library of Congress Cataloging in Publication Data
A catalogue record for this book has been requested
ISBN 0-203-99140-0 Master e-book ISBN
ISBN 0-415-01805-6 (hbk)
ISBN 0-415-11668-6 (pbk)
Contents
Acknowledgements vi
Abbreviations vii
Introduction 1
Part I Sociology, professions and the public interest: a
research framework
1 The sociology of professions and the professional altruism 11
ideal: a critical review
2 The development of a viable conception of the public 35
interest
3 The role of professions: power, interests and causality 71
Part II An empirical application: the response of the medical
profession to acupuncture in Britain
4 Alternative medicine: the case of acupuncture 103
5 Potential explanations for the rejection of acupuncture in 139
Britain
6 Acupuncture and British medicine: the influence of 185
professional power and interests
7 The medical reception of acupuncture in Britain: 229
professional ideologies and the public interest
Conclusion 259
Appendices 267
Bibliography 271
v
Author index 301
Subject index 311
Acknowledgements
This book could not have been completed without the assistance of many
individuals and institutions too numerous to single out for thanks here. I would,
however, particularly like to extend my appreciation to Michael Burrage from
the London School of Economics for his support and to the Social Science
Research Council for funding the initial research. I also owe a special debt of
gratitude to my wife, Maj-Lis, and my children, Jonathan and Laura, for their
forbearance throughout the enterprise. Finally, thanks are due to Anita Bishop,
who assisted with the typing of the manuscript.
Abbreviations
AMA American Medical Association
BAA British Acupuncture Association
BMA British Medical Association
BMAS British Medical Acupuncture Society
BMJ British Medical Journal
CCAM Council for Complementary and Alternative Medicine
CFA Council for Acupuncture
DoH Department of Health
GMC General Medical Council
ICM Institute for Complementary Medicine
IROM International Register of Oriental Medicine
MAS Medical Acupuncture Society
MRC Medical Research Council
NHS National Health Service
PMSA Provincial Medical and Surgical Association
PMSJ Provincial Medical and Surgical Journal
RCP Royal College of Physicians
RCS Royal College of Surgeons
RTCM Register of Traditional Chinese Medicine
SA Society of Apothecaries
SMN Scientific and Medical Network
TAS Traditional Acupuncture Society
UKCC United Kingdom Central Council for Nursing, Midwifery
and Health Visiting
WHO World Health Organization
viii
Introduction
In popular usage the term ‘profession’ has a wide variety of connotations,
spanning from a highly skilled and specialized job to any fulltime work from
which income is derived (Freidson 1986). The boundaries of interpretation are
narrower in sociology, but sociologists have also still to reach agreement about
the meaning of the term ‘profession’ and the related question of which
occupations are to count as professions. However, despite the absence of an
unequivocal definition (Abbott 1988), most sociologists have for long
acknowledged the growing importance of professions in Western industrial
societies in the twentieth century. Millerson (1964), for instance, notes that
roughly two dozen new qualifying associations were formed in each decade of
the first half of the century in England, whilst Ehrenreich and Ehrenreich (1979)
point to the rapid expansion in the range of professional occupations in more
recent times on the other side of the Atlantic. This trend, moreover, is widely
held to be paralleled by a major growth in the numbers of professionals in the
work-force (Ben-David 1963; Goldthorpe 1982). Giddens (1981), indeed, has
suggested that the proportion of professional workers in neo-capitalist societies
has trebled since 1950, reaching as high a level as 15 per cent of the labour force
in the United States—a pattern of expansion which is in part associated with the
rise of the welfare, enterprise and information-based professions (Watkins et al.
1992). And, as if to underline the importance of what are assuredly some of the
most privileged and prestigious strata in society (Portwood and Fielding 1981),
Halmos (1970) claims that the political power of professionals has escalated too.
To be sure, professions have sometimes come under political attack from
Western governments in the contemporary era (see, for instance, Burrage
1992), but nonetheless they have increasingly insinuated themselves into
positions of power since the turn of the century by becoming more directly
involved in both national and local government.