Emerging from the shadow of medicine: allied health as a ‘profession community’ subculture

Abstract

The authority relationship between medicine and the allied health professions has been conceptualised as one of subordination. The research that underpinned the subordination thesis was largely based on pre-1980 studies of interprofessional interaction and struggle. This article presents data from a comparative longitudinal case study analysis of Australian allied health professions employed in three distinct organisational models in urban acute care general hospitals during the 1990s. The article discusses the emergence of a distinct allied health 'profession community' subculture associated with the emergence of new organisational structures in Australia. A model to account for subculture development under different organisational conditions is proposed. A key concern is the way in which a 'profession community' is created, structured and maintained in the complex organisational settings of the acute care hospital. The findings challenge the notion that subordination is an inevitable consequence of medical dominance and calls for a reformulation of our understanding of the relationship between medicine and allied health professions in light of contemporary health service reforms. (author abstract)