19 Neo-functionalism

Abbott’s work is particularly notable here because it broke with the classical functionalist belief in the need for social stability, and looked, instead, at inter-professional competition. Abbott was interested in the ways that disputes over local professional jurisdictions caused professions to develop in idiosyncratic ways, rather than as orderly progress. His work remained broadly functionalist because his interest lay in developing a generalisable ‘system’ for understanding the development of the professions, but he was much more interested in who was doing what to whom, and the internal conflicts that tended to disrupt social order, rather than secure it.

Abbott’s work has featured in a number of physiotherapy studies in recent years ^{[1][2][3][4][5][6][7][8]}.

In Pauline Norris’s article, How ‘we’ are different from ‘them’ ^[9], in particular, Abbott’s thesis that ‘professions form an interlocking system in which they compete for work’ (ibid, p.25), plays a prominent role. Focusing on the contested field of musculoskeletal practice, Norris studied medical specialists, general practitioners, physiotherapists, chiropractors, osteopaths, massage therapists, and a range of other practitioners, both orthodox and alternative. Her findings reinforce Abbott’s argument that it is not claims to scientific knowledge that define professional identities in practice, but the relationships between competing professions.

What these studies point to, is the enduring power of functionalism as a way to make sense of what physiotherapy is. Functionalism has had a powerful influence on the sociology of all professions though, especially in healthcare, where it was the most important and widely cited approach shaping the aspirations of the new professions that emerged in the early part of the 20th century. In health care, functionalist research showed how a profession could aspire to be like medicine; how to build a relationship with the public and the state; how to operate for maximal efficiency, objectivity and productivity; and how to carve out a distinctive position in an increasingly competitive marketplace.

It would be fair to say that through the 1930s, 40s and 50s, functionalism was the most important ideology shaping the professions as social entities. But life for many people after WWII disrupted not only our beliefs about the professions, but about so many other things too: gender and sexuality, race relations, attitudes towards war, human rights, disability, ecology, music, drugs, technology and the media. Perhaps not surprisingly, the values and principles that had made functionalism seem so obvious in the 1930s began to be questioned in the 1960s, leading to revolutionary new ways to think about society and the ways it had been organised. So, what did critics claim was now wrong with functionalism?