For love or money: Commodification and the construction of an occupational mandate
Tagged: Sociology (RSS) Occupations (RSS), altruism (RSS), interaction order (RSS), occupational mandate (RSS), commodification (RSS), gift economy (RSS), professionalization (RSS), occupational status (RSS)
Nelsen spent eleven months as a participant-observer in four Emergency Medical Services (EMS) groups. She was trained as an EMS worker, and went on dozens of emergency response calls. She also interviewed a number of medical professionals (e.g. nurses, doctors) as well as firefighters and police officers who interacted with EMS workers.
After setting the theoretical stage (see below), Nelsen and Barley recount the history of EMS work. Volunteer EMS squads began to appear in the late '50s and it was only by the '90s that communities began relying on a mix of volunteers and professionals. A federal act in '73 recommended standardized training and certification for EMS workers, but made no requirement regarding their compensation (or lack thereof). There was therefore no preexisting social structure (law, in this case) that EMS workers could appeal to in order to justify and propagate their frame on their work.
Nelsen and Barley (I presume) used a grounded theory approach to analyze Nelsen's fieldnotes and interview data, deriving a series of scripts (they don't name them as such, but they bear a striking resemblance to those in Barley's seminal paper on CT scanners). They go on to describe how paid and unpaid EMS workers deploy these scripts in order to secure their status.
In short, paid EMS workers received more intensive training and were held to higher standards, and this allowed them to both adopt scripts associated with professionalism (e.g. consistency, rationality) and with professionalized medicine in particular. Nelsen and Barley share ethnographic data that indicates the paid EMS workers used these scripts to denigrate their unpaid counterparts in a way that also increased their own status in the eyes of those that make proximate decisions about their status as professionals.
Theoretical and practical relevance:
Nelson and Barley make at least two important contributions here. Previous scholars had assumed that professionalization occurred via an appeal to/interaction with societal structures (e.g. law, policy). While supporting this view, they also claim that scholars have overlooked a crucial, early-stage mechanism: Goffman's "interaction orders". Nelson and Barley hold that the content and process of conversations at the front lines determines occupational status (in this case, conversations involving volunteer and paid EMS workers, patients, medical professionals, firefighters and police) as much as social structure does.
Their second contribution is to examine the commodification of labor. In their view, anything that becomes a commodity was previously an object of altruism - a gift. They thus open the door to the interaction between the sociological dynamics associated with gift giving and altruism and the sociological dynamics associated with commodified labor. Occupations in transition from one to the other (e.g. EMS) provide a unique opportunity to witness the dialectic between these two logics.