9 Trait theory

One of the questions that the idea of social solidarity created was why certain professions became elite and others did not. Why, for instance, had medicine and not, say, bone setting or homeopathy, become the dominant voice in healthcare and the primary mechanism through which societies sought to restore health and stability? The answer to this question lay in what functionalists called the traits, or characteristics, of different professions. By studying those professions who have succeeded in gaining social respectability, functionalists arrived at a set of traits that demarcated the elite professions from the more prosaic semi-professions and occupations. Talcott Parsons’ work became particularly important here.

Parsons saw that contemporary medicine had successfully navigated the complex relationships that existed between the state and its people, and had helped to create the services, structures, and systems necessary for social order. Echoing Parsons’ functionalism, Victoria Sparkes, writing about physiotherapy professionalisation suggested that, ‘Society provides a demand for the services of a profession, which in turn maintains its elevated position in the social strata, chiefly because society is unable to realise the service for itself’ ^[1]. As Parsons saw it, the doctor’s role was to identify disease, illness, and other forms of what the functionalists called ‘social deviance’, and to act as ‘agents of social control’ ^[2]. Patients were expected to defer to the doctor’s authority, and seek appropriate help when their lives fell out of balance as a result of illness or injury. As compensation for their work in nurturing social solidarity, doctors were given powers of self-regulation — the much sought after professional autonomy — and significant financial rewards, in part to reduce the temptation to financially exploit their patients. Other checks and balances were also drawn up to prevent doctors taking advantage of what had effectively become a healthcare monopoly. And so only those professionals who could demonstrate the highest levels of probity and altruism were recognised by the state through professional registration and protective legislation.

A key feature of Parsons’ functionalism was the belief that the patient’s deference to medical authority, and their compliance with medical instructions, were necessary contributions to social order. In this way, the patient absolved themselves ‘from the responsibility for the management of their illness’ ^[3]. Perhaps the best example of this was Parsons’ now famous concept of the sick role.