This Al Jazeera International photo shows a helicopter water bombing during last year's Australian bushfires. The point of the photo is that once you have to start putting out fires from on-high you are already in trouble. It is generally better to deal with the fire at source while it is small, and that comes back to improved management.
I have been musing about issues associated with professional practice, trying to clarify and structure some confusions in my own thinking. One of my key concerns has been a feeling that I need to find a better way to focus, link and present my own writing and thinking to make it more accessible.
Three Overlapping Knowledge Domains
In an earlier post, Towards a Discipline of Practice, I suggested that there were three overlapping knowledge domains within professional services:
1. The profession itself, whether it be engineering, medicine, law or training. What we do. Most professional education and training focuses on this.
2. The application of the profession in practice by individual professionals. Doctor/patient, lawyer/client etc. Essentially, how do we do what we do.
3. The management of the overall practice. Essentially, how do we manage what we do. I am using the term practice in the broad sense to cover the variety of business structural arrangements found within professional services.
We can think of these domains in terms of a matrix with the three knowledge domains and their various subdivisions down one axis, the various professional services fields and their subdivisions along the other.
The Challenge
When I began this blog my focus was, as the blog name suggests, on number 3, the management of the professional services practice. This remains my core focus. However, I have in fact found myself writing across all three knowledge domains.
The problem with this is that it can create confusion in the minds of individual readers. To tease this out a little, hopefully encouraging debate, I am now going to look briefly at the first two knowledge domains.
Knowledge Domain One: the Individual Profession, Knowledge Domain Two: Application of the Profession in Practice
While these two areas are very distinct, I have linked them together because collectively they bear upon one of my key interests, ways of enhancing cooperation between professions to facilitate true multidisciplinary working. This links to a second interest, the extent to which professions can learn from each other.
Originally, there were arguably three great professions, law, medicine and theology.
One of the features of the process of professionalisation was the way each developed its own knowledge domain, creating a separation and mystique from other fields of human activity and knowledge. Linked to this was the creation of self-governing processes giving the profession the capacity to define and recognise its own practitioners. As other professions emerged, they attempted to follow the same route, creating a professionalisation process.
In saying this, I do not want to become involved in the debate as to what constitutes a true profession. To me, the key distinguishing feature here is that a profession has a focus on the work of the individual professional. Rather, my concern is on the way professions and professionalisation create intellectual and cultural divides that limit cooperation and knowledge transfer between professions.
To some degree these divides are both inevitable and necessary. Every profession needs its own language, its own defined areas of knowledge, to facilitate development of and work within that profession. But problems arises when the divides are such that they blind professions (and professionals) to the gains that can arise from cooperation and cross-fertilisation. Problems can also arise for professions and professionals where professional barriers act to prevent the profession responding too needs that they were created to serve.
Let me try to illustrate all this by an Australian example.
Ophthalmology and Optometry
In Australia as in many other countries, there have been concerted efforts at official level to break down competitive barriers previously protecting the positions of certain professions. These efforts have been opposed by some professions under perceived threat, at times supported by professions who saw potential gains.
As part of this process, there were moves in different Australian states to grant optometrists prescribing rights for certain drugs, thus broadening the range of optometric practice. These moves were opposed by many ophthalmologists and by the Royal Australian (now Australian and New Zealand) College of Ophthalmologists on the grounds that optometrists lacked the knowledge, skills and judgement required to diagnose, prescribe and treat safely.
Despite these objections, the Victorian Government decided to grant certain certain prescribing rights and then asked the College to specify what additional training should be required before individual optometrists could exercise those rights.
The outcome here is described in a case study on the Ndarala Group blog. To provide the necessary advice, the College had to specify just what knowledge and skills were required to diagnose and prescribe safely and effectively so that this could be embodied in training activities. To do this it adopted a competency based approach, applying knowledge and skills drawn from the training profession. In turn, this has fed on into major changes in the approach adopted to the training of ophthalmologists in Australia and New Zealand.
The Lessons
All this may sound a bit arcane, but if we look at the case it does have broader relevance and not just to Australia.
To begin with, this project combined knowledge domain one (what we do) and two (how we do it). The College actually had to specify key elements in both and show how they were related.
This brings me to my second point. In doing this, the College laid down a methodology capable of application across the professions, one with the potential to demystify professions and, in so doing, to lay the basis for broader cooperation while also opening individual professions up to greater competition.
This may sound extreme, but consider this.
Both Canada and Australia face a problem in regional areas because of an aging lawyer population. Young lawyers are reluctant to take on country general practice positions, preferring instead to look to bigger city specialisations. I may argue that this does not make sense in financial terms if you look at average financial returns, but it is (I think) a practical reality.
Track forward. If certain areas cannot get conventional legal services, then other ways will have to be found to give them that service.
One way of doing this, one that is already happening with conveyancing, is to take out chunks from legal services and allow others to provide the services involved. Another alternative, again one that is already happening, is to move to on-line delivery of certain legal services. These two could, of course, be combined.
Add in the emergence of both corporatised law firms and multi-profession firms including lawyers. At what point do we move to listed entities combining a variety of delivery modes and professional areas?
The initial move to float Integrated Legal Holdings as Australia's first listed law firm ran into a variety of problems including opposition from current legal regulators, although the float is likely to proceed in February. However, this is just a first straw in the wind.
My feeling is that the dynamics already in place guarantee major change over the next few years. I also think that within this change process, the capacity to define knowledge domains in the approach pioneered by the ophthalmology case is going to become increasingly important.
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