Post-professionalism — Part 2 – Atomisation and the arrival of late capitalism
Over the next few weeks, I want to give some thought to the drivers of post-professionalism.
There are no end of challenges now facing the health professions, but can we define some of the principal drivers of the post-professional movement specifically?
Most of the literature points to three main discursive forces behind the idea that the professions will be removed from the centre of healthcare thinking and planning over the next decade or so:
Atomisation under late capitalism
The unbundling of goodness and expertise
Digital disruption
Let’s begin with the first of these.
The emergence of late capitalism
Late, or advanced, capitalism is so called because of the distinctive way it reimagines the capitalist project of unlimited growth and progress.
Where early capitalism generally referred to the period from the 17th to the 20th centuries, and is synonymous with the industrial revolution and the development of high-income economies in the West, late capitalism has really only emerged since the 1970s.
Early capitalism functioned by feeding domestic growth with the expansion (read, forced colonisation and enslavement) of other territories and peoples. As resources for growth became depleted at ‘home’, colonial enterprises reached across the globe to feed continuing growth.
In many ways, the birth of the orthodox health professions – along with many others within the professional classes (administrators, public servants, teachers, and so on), – derives from the need to have an ‘enabling class’ of trusted, regulated, and socialised workers who could perform the necessary ‘soft’ colonisation as a marker of the ‘civilisation’ and ‘ruthless benevolence’ (Fitzpatrick and Protschky 2009) of the colonial power.
By the middle of the 20th century, however, attitudes towards aggressive colonisation, land disposition, wars and treaties of convenience, the imposition of Western cultural systems, religious missionary work, and other forms of asynchronous power came under increasing critical scrutiny.
What precipitated the move away from early capitalist ideologies, however, was not growing public consciousness, but rather the twin forces of declining domestic prosperity and increasing unavailability of new lands and peoples to exploit.
Fortunately – and here it hardly bears mentioning that I am being ironic – a solution was found to invert the logic of early capitalism and exploit a new, inconceivably vast, previously untapped market: a market that would have profound implications for healthcare.
New forms of capitalism began to emerge in the mid-1970s with a raft of neoliberal economic reforms, new forms of global economic market speculation, and the automation and restructuring of commodity supply chains.
At a superficial level, these seem quite dry, economic and political changes. But what day did was to turn the idea of unlimited growth and expansion inwards. Instead of looking overseas for new lands and people to exploit, late capitalism has turned inwards; towards individual people: towards people’s bodies, people’s lifestyles and habits, people’s relationships, and people’s work.
In fact, every possible facet of human existence was turned into its own specialised field, replete with commodities and consumer goods, as well as a raft of dedicated advisors, analysts, coaches, counsellors, experts, influencers, practitioners and therapists.
In effect, every single aspect of human life has been atomised: turned into its own market. And the possibilities for unlimited growth — and the future for a new form of capitalist exploitation — appears restored.
This has obvious implications for all of the established health professionals because, on the one hand, we have seen a vast new field emerge in which the knowledge and skills we once commanded have taken on new relevance. But, on the other hand, this newly ‘atomised’ human being has been opened up as a market for any and all who can find an as yet un-tapped economic opportunity.
Late capitalism is forcing the complete reorganisation of the orthodox health professions, but it is only one of the main drivers of change we need to consider. Next week I will look at the second of these drivers – the unbundling of goodness and expertise.
References
Fitzpatrick MP, Protschky S. (2009). Families, frontiers and the new imperial history. The History of the Family. pp. 323-326.