Situated Professionalism: Navigating Competing Institutional Logics of Professionalism and Market

Abstract

I develop a theory about situated professionalism by exploring how professional actors navigate the conflicting institutional logics of professionalism (with its emphasis on norms, ethics and reputation) and the market (which foregrounds self-interest and financial performance). Rather than being transitionary or short-lived, the presence of these two conflicting logics is enduring and shapes the day-to-day activity patterns of these professional actors by enabling them to draw on aspects of either logic depending on the situation. I propose and test a set of theoretical propositions highlighting that the accessibility and salience of the professional logic as a driver of professional action depends on environment- and task-related factors. Using a difference-in-difference empirical approach, I test the hypotheses on the large population of fee-for-service physicians in the province of Ontario, Canada over a four year period. In particular, I examine how these professionals’ activity patterns change in response to financial incentives. The results indicate that while professionals do draw from the market logic, the professional logic is more salient and accessible in two situations: (1) in larger organizations with characteristics – such as peer monitoring and routines – that reify the professional logic; and (2) in situations where a response to incentives is in greater potential conflict with professional norms.