fighting the enemy within? challenging minor principles of professionalism in care and welfare

Wilensky’s seminal article on professionals mentions three identifying characteristics besides the familiar specialized knowledge, autonomy and professional ideology. These are the referral principle, which states that professionals should refer clients to a colleague with a different specialty if necessary, the principle of sloughing off, which dictates that professionals allocate less rewarding parts of their job to lesser paid assistants, and the principle of impersonal service delivery, which admonishes professionals to treat clients equally. A changing clientele in health care and social care warrants a reappraisal of these three principles. Population ageing necessitates a reappraisal in health care. The deinstitutionalization of people with psychiatric or mental disabilities necessitates a reappraisal in social care. Referral, sloughing off and impersonal service delivery are professional characteristics that concur with managerial or political objectives. Managers and politicians are partly responsible for their widespread application. Hence, professionals need their help to fight this “enemy within professionalism.”