Organizational Powers: Capture of Professional Jurisdiction in the Case of U.S. Retail Clinics
Roman V. Galperin
Johns Hopkins University
September 12, 2014
Johns Hopkins Carey Business School working paper
This paper advances the theory of the division of professional labor by including organizations as actors capable of entering markets protected by professional monopoly, capturing professional jurisdiction and altering the system of professions. Using the case of retail health clinics in the U.S., the paper suggests a strategy that allows organizations to overcome the barriers of legal license and cultural authority protecting professional jurisdiction. In the case, retail clinic organizations changed the nursing profession’s jurisdictional settlement with physicians in a way that benefitted neither profession, but allowed the organizations to capture the professions’ rents. Retail clinic organizations thus inserted themselves into the interprofessional competition and acted as meta-professions, an outcome that does not fit the existing theory. To explain this outcome, the paper elaborates the theory by reconceptualizing jurisdiction as rights and their use, introducing jurisdictional work as a process connecting the two components of jurisdiction, and recognizing the problem of professional collective action. The resulting model allows organizations to exert effective control over a professional jurisdiction and extract related rents without explicitly holding the jurisdiction. Implications for deskilling of professional work are discussed.
Number of Pages in PDF File: 57
Keywords: Occupations and Professions, Professional Jurisdiction, Occupational License, Ecological Models, Organization Theory, Collective Action
JEL Classification: J44, D45, I11
Date posted: June 27, 2011 ; Last revised: September 25, 2014
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