Organizational Powers: Capture of Professional Jurisdiction in the Case of U.S. Retail Clinics
Johns Hopkins Carey Business School Working Paper
54 Pages Posted: 27 Jun 2011 Last revised: 30 Mar 2017
Date Written: March 29, 2017
How do corporations claim professional jurisdiction? Corporations are capable of commodifying professional work through innovation and therefore may compete with professions for the performance of expert tasks, reducing the inefficiencies of professional monopoly. Yet current theories of professional work predict resilience of professions to such competitive threats. This paper analyzes the rise of a new organizational form in the U.S. primary care field — retail health clinics — to advance the ecological theory of professions by including corporations as collective contenders for professional jurisdiction. Retail-clinic chains overcame jurisdictional barriers of licensure and cultural illegitimacy by recruiting medical “front-professionals,” who brought formal rights to perform the tasks and allowed the corporations to make jurisdictional claims. The diversity of governing logics in medicine, signified by the availability of front-professionals, also allowed the clinics to secure alliances with incumbent organizations and thus to achieve integration into the field. Improved theory of professional jurisdictions is proposed by recognizing that (i) individual professionals, by moving across organizational forms, may shape organizations’ capacity to make jurisdictional claims, and (ii) effective jurisdiction combines rights related to expert work and means to exercise and defend the rights. Imbalance between rights and means creates an opening for corporate entry.
Keywords: Occupations and Professions, Professional Jurisdiction, Occupational License, Ecological Models, Organization Theory, Collective Action
JEL Classification: J44, D45, I11
Suggested Citation: Suggested Citation