Shifting discourses of professionalism: a case study of general practitioners in the United Kingdom

Abstract

This paper addresses shifting constructions of professional identity in the context of debates about reflexive modernisation and the changing role of professionals in the provision of primary healthcare. Data are drawn from interviews with 20 early-career general practitioners (GPs), who accounted for their orientations towards work in rather different ways from those typically reported in much primary care research. In particular, they reported high job satisfaction and success in achieving what they called 'nice work'. We argue that these GPs typify a shift in discourses of professionalism, characterised by respondents as the 'new general practice', which explicitly rejects many values attributed to 'traditional' general practice. Within the 'new general practice', professionalism has been de-coupled from some of the paradigmatic traits of traditional rhetorical accounts (such as vocation), and has significantly reframed others. Despite policy concerns that a retreat from 'vocational' professionalism will lead to reductions in service quality, we argue that this is not inevitable. The 'new general practice' resonates with the social values of reflexive modernisation, and has the potential to enable new, less paternalistic, forms of relationships with clients, although it remains to be seen whether this potential is realised in healthcare delivery.