When I think about other processes of deprofessionalization besides those in academia in the United States over the last thirty years, I find it relatively easy to answer the question who benefits?
The health-care system in particular provides some very easy answers. By shoving doctors, nurses and other highly trained health care workers out of primary authority for many decisions about the provision of care and the administration of hospitals, practices, trauma centers and so on, two rising groups of managerial professionals have taken a big cut of the money coming in the door for themselves as direct compensation—administrators at the top of major institutions like hospitals and insurance professionals specializing in health care. Far more consequentially, a lot of the money now goes out the door directly to the insurance industry, whether the health care institution in question is non-profit or otherwise.
Pushing doctors, nurses and highly skilled technicians out of direct administrative authority also provides a net benefit to all the other industries connected to health care. The medical-industrial complex makes far more money (and conceals the real costs of manufacture and service) when it is making direct corporate deals with insurers and hospital or center administrators. Doctors and technicians end up just as end-users of devices, data systems, and so on, whose feedback is (supposedly) welcomed but who for the most part are increasingly not in the loop of decision-making about the tools that they have to work with and certainly are in no position to refuse a data system they find objectionable. Doctors in practices do get some degree of say-so about prescriptions, which is why pharmaceutical representatives visit them endlessly, but at the level of whole facilities, that’s another decision made substantially outside the loop of individual judgment or preferences.
None of what has changed in American health care needs to have been done with the clear intent to favor those interests while disfavoring professionals. It wasn’t a plot or a conspiracy, at least in its origins. But it is one of those kinds of changes that accelerates relentlessly once it takes hold, because the new configuration of institutions that take in gigantic amounts of money and dispense gigantic amounts of money is not only immensely rewarding to those interests that have taken a big piece of the action, it is a food source that can and has nourished many newcomers.
I’m not sure this is the same picture, quite, as with academia. The story of how administrations became more powerful and faculty become far less so, and how faculty jobs at many universities became substantively worse and far less secure in their terms, has some resemblances. And yet, for all that they’ve been elbowed out of authority and centrality in many medical institutions, doctors have retained a stronger or more respected claim on critical parts of health care, both by law and expectation. Students in institutions where they are taught almost entirely by contingent faculty and where the steering wheel of the curriculum has been grabbed by administrative leaders and state legislators may not really see the difference until they’re graduated (or perhaps not even then), but patients who never see a doctor and are denied coverage of a procedure by an insurer definitely know the difference.
What I’m thinking about today as I walk down this line of reasoning is “what about the equivalent of the pharmaceuticals, the medical technology producers, the specialized billing agencies, and so on? Do they benefit from the deprofessionalization of faculty, from these changes to the university?”
One group of professionals that I know benefit are people who are prepared and willing to serve as providers of “content” that doesn’t require faculty expertise to vet or choose, whether it’s some form of paracurricular enhancement, some form of compliance, or just plain full-out replacement of faculty with less expensive labor. Not everybody in that loose grouping is the same, and many of them have no interest in displacing faculty per se. But the less that faculty are expected to be (or wanted to be) full participants in institutional governance the more need there is for a potentially vast range of other professionals to fill in some of the gaps. This is where the dream of ed-tech companies and investors is centrally focused and why they make no bones about wanting to break the power of academically-trained faculty once and for all: they want to “disrupt” a whole reserve army of people with other credentials (or no credentials) into online provisioning of instruction on a massive scale. They’re not doing it for the benefit of all the people who would be employed in such a role, any more than Uber is an act of altruistic beneficience towards Uber drivers.
I think it’s more ambiguous with for-profit publishers. They’d definitely like to have pesky faculty and librarians out of their hair in certain ways, but at the same time, the machinery of publish-or-perish at the heart of the fading tenure system was good for them. This is what I think is wrong with Steven Mintz’ analysis of the “utter disarray” in scholarly publishing in the humanities. He argues it’s not about the money only, but it really is. It’s not that people need to be paid directly for all the work that was given away for free to institutions and to for-profit publishers, but it is that all the forms of indirect payment are nearly extinguished. Tenure was the most powerful form of it—job security was compensation, and when you don’t have it, you aren’t inclined to do those forms of work. Subsidized time and travel for scholarship was another form of compensation that is hard to come by now. And the respect and understanding of administrative leaders for scholarship and the life of the mind was a more psychic, less monetary, compensation, and at many institutions that’s gone too. Few presidents, provosts or academic deans show curiosity, wonder or love for the content of scholarly work. That’s another route into deprofessionalization. I think in the case of for-profit publishers, that might be at least a serious illness for the goose that laid the golden eggs if not outright murder.
But at least some of the forces working to deprofessionalize academia seem ideological rather than pecuniary. American health care became more expensive and less effective as insurers, managers and sellers elbowed medical professionals out of the loop of decision-making, to the point of making it the biggest joke in the developed world. American academia still retains some of its luster outside of the the United States, partly because of its multiplicity but also—despite it all—its quality. As it is beset from many sides and faculty are more and more derogated, I’m not sure there are coffers filling up from that change.
I’m curious what my readers think. Who benefits, financially, from the deprofessionalization of American faculty? Are they conscious of that, if so?
Image credit: Photo by Josh Appel on Unsplash
The uncomfortable answer is that the primary beneficiaries of removing responsibility for managing the university from tenure track faculty is precisely the faculty themselves. Particularly if those faculty want to focus on their disciplinary research, their upper level teaching, their graduate students.