Private Wisdom and Public Practice: Formation and Governance in the Medical Profession in the United Kingdom

Abstract

In 2006, the Chief Medical Officer for England published the report Good Doctors, Safer Patients in a call for strengthened regulation of the medical profession. The changing relationship between patients and doctors in the United Kingdom arises from the interplay between societal expectation and clinical governance, personal formation and professional practice, private being and public doing. The wisdom of professional practice is in the habits of professionals, a practical wisdom that is the reflex of professional identity. Socialization into a profession is the formation of such identity through the legitimate peripheral participation of the apprentice, oriented towards the contingent granting of admission to the community of practice. The conditional nature of continued insider status, permitting members to interact with clients across the professional boundary, is essential to the contract through which the profession enjoys the privileges conferred by society. The governance of the profession is therefore also necessarily circumscribed, a political reality that is currently evidenced in the regulation of medical practice in the United Kingdom.

Keywords:

• Professionalism
• Ethics
• Medicine
• Regulation
• Governance
• Community of Practice
• Identity
• Apprenticeship

Additional information

Notes on contributors

Al Dowie

Al Dowie is an educator who has taught in Scottish medical schools across a range of biomedical subject areas since 1998, and specializes in medical ethics, law, and patient safety. His doctorate is in ethnographic research

Anthea Martin

Anthea Martin has a medical background in general practice and is a Member of the Faculty of Forensic and Legal Medicine. She holds a postgraduate degree in medical law, and is a medico-legal adviser