Chapter 1 Foci: Market Liberalization and the Changing Nature of Professional Work

2021 ◽  
pp. 23-44
Author(s):  
Richard Susskind ◽  
Daniel Susskind

We arrive now at the theoretical heart of the book. In Chapters 2 and 3 we describe how the professions are changing. In Chapter 4 we explain these changes by reference to the information substructure and developments in technology. In this chapter we draw these observations and arguments together. First we develop a model to show how professional work is evolving. Then, building on all we have said and done so far, we step away from the professions and describe the people and systems that will replace them in the future. In broad terms, our focus in this chapter is on the way that we handle a particular type of ‘knowledge’ in society. We are, of course, not alone in exploring this concept. All manner of scholars have applied their minds to ‘knowledge’ over the centuries. Philosophers, for example, who specialize in epistemology ask such fundamental questions as ‘what is knowledge?’ and ‘how can we know anything?’, or again, ‘of what knowledge can we be certain?’ Sociologists study the connections between knowledge and power, culture, and class. Lawyers handle questions about the ownership, protection, and sharing of knowledge. Information theorists consider the relationships between knowledge, information, and data. We are fascinated by each of these perspectives, but for the most part they fall beyond the scope of our work. Instead, the particular type of knowledge that is our preoccupation is what we introduce in Chapter 1 as ‘practical expertise’. Now we explore this concept in greater detail, looking at how we currently create and share it, and how we might handle it differently in the future. We seek to show, in economic terms, that knowledge has special characteristics that make its widespread and low-cost production and distribution both possible, and desirable, in a technology-based Internet society. Practical expertise, or our conception of it, is the knowledge that is required to solve the sort of problems for which the professions, traditionally, were the only solution—the knowledge that is used to sort out a health worry or resolve a tax problem, for example.


2000 ◽  
Vol 5 (5) ◽  
pp. 4-5

Abstract Spinal cord (dorsal column) stimulation (SCS) and intraspinal opioids (ISO) are treatments for patients in whom abnormal illness behavior is absent but who have an objective basis for severe, persistent pain that has not been adequately relieved by other interventions. Usually, physicians prescribe these treatments in cancer pain or noncancer-related neuropathic pain settings. A survey of academic centers showed that 87% of responding centers use SCS and 84% use ISO. These treatments are performed frequently in nonacademic settings, so evaluators likely will encounter patients who were treated with SCS and ISO. Does SCS or ISO change the impairment associated with the underlying conditions for which these treatments are performed? Although the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) does not specifically address this question, the answer follows directly from the principles on which the AMA Guides impairment rating methodology is based. Specifically, “the impairment percents shown in the chapters that consider the various organ systems make allowance for the pain that may accompany the impairing condition.” Thus, impairment is neither increased due to persistent pain nor is it decreased in the absence of pain. In summary, in the absence of complications, the evaluator should rate the underlying pathology or injury without making an adjustment in the impairment for SCS or ISO.


2000 ◽  
Vol 5 (6) ◽  
pp. 1-7
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage ◽  
Leon H. Ensalada

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is available and includes numerous changes that will affect both evaluators who and systems that use the AMA Guides. The Fifth Edition is nearly twice the size of its predecessor (613 pages vs 339 pages) and contains three additional chapters (the musculoskeletal system now is split into three chapters and the cardiovascular system into two). Table 1 shows how chapters in the Fifth Edition were reorganized from the Fourth Edition. In addition, each of the chapters is presented in a consistent format, as shown in Table 2. This article and subsequent issues of The Guides Newsletter will examine these changes, and the present discussion focuses on major revisions, particularly those in the first two chapters. (See Table 3 for a summary of the revisions to the musculoskeletal and pain chapters.) Chapter 1, Philosophy, Purpose, and Appropriate Use of the AMA Guides, emphasizes objective assessment necessitating a medical evaluation. Most impairment percentages in the Fifth Edition are unchanged from the Fourth because the majority of ratings currently are accepted, there is limited scientific data to support changes, and ratings should not be changed arbitrarily. Chapter 2, Practical Application of the AMA Guides, describes how to use the AMA Guides for consistent and reliable acquisition, analysis, communication, and utilization of medical information through a single set of standards.


2014 ◽  
Vol 58 (3) ◽  
pp. 111-124 ◽  
Author(s):  
Sonja Sobiraj ◽  
Sabine Korek ◽  
Thomas Rigotti

Men’s professional work roles require different attributes according to the gender-typicality of their occupation (female- versus male-dominated). We predicted that levels of men’s strain and job satisfaction would be predicted by levels of self-ascribed instrumental and expressive attributes. Therefore, we tested for positive effects of instrumentality for men in general, and instrumentality in interaction with expressiveness for men in female-dominated occupations in particular. Data were based on a survey of 213 men working in female-dominated occupations and 99 men working in male-dominated occupations. We found instrumentality to be negatively related to men’s strain and positively related to their job satisfaction. We also found expressiveness of men in female-dominated occupations to be related to reduced strain when instrumentality was low. This suggests it is important for men to be able to identify highly with either instrumentality or expressiveness when regulating role demands in female-dominated occupations.


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