Ouvrir le menu

NEOMA's world

Thematics :

How have some people working in patient, client or consumer-focused professions reinvented their practices of their own volition? In a recent article published in Administrative Science Quarterly, Nishani Bourmault, researcher at NEOMA, and her colleague have examined this question, preparing the ground for a better understanding of the wider transformations taking place in the world of work.

The mounting pressure generated by the challenges facing society, such as climate change or social justice, means that some professionals have to re-invent their work. And yet scientific research has shown that this type of approach is difficult when skilled workers are deeply attached to the values they associate with their profession. Nurses, for instance, consider it is not appropriate to show affection to patients, whereas nursing auxiliaries view it as crucial for doing a good job. As a result, many individuals are opposed to changes that would run counter to their professional culture. Such was the case among librarians when they saw their role change drastically in the face of digital technology.

Despite these objections, professionals have always managed to evolve over the centuries. And with good reason: revolutions often arise from pressure from outside, such as the need to onboard new technologies or incorporate regulations, in which case professionals are obliged to adapt. They make the transition by leaning on their peers, who are all in the same boat. In rarer cases, it sometimes happens that individuals – rather than entire professions – voluntarily reboot their work. This stance is encapsulated in the words: “I change because I want to”, and it has seldom been explored up to now – which is why the researchers attempted to understand how medical professionals embarked on their journey.

The case of anaesthesiologists and hypnosis

The researchers focused on how anaesthesiologists in France have taken up the practice of hypnosis. Although it has been authorised as an addendum to or in place of chemical anaesthesia since 2011, hypnosis is still a marginal practice. As of 2015, only 10% of anaesthesiologists had completed a hypnosis training in France. Integrating this way of doing things challenges the basic principles of a profession that considers itself Cartesian, with a particular attachment to science-based evidence. How did anaesthesiologists manage to embrace hypnosis and its intangible quality when everything seems to run counter to their values?

In the first instance, we might instinctively assume that professionals reboot their work because they feel the need to. But, against all expectations, the researchers show that personal beliefs do not a priori play a key role. Quite the opposite: most of the anaesthesiologists who took up hypnosis did not believe in its potential before trying it out. The reinvention of these specialists was based on two key levers: first, their own experiences of the practice with patients. Performing medical hypnosis renewed their interest in the practice, even without completely understanding the science behind its success. Secondly, their relationships with their patients: these key beneficiaries of this new practice sung its praises so much that they convinced the anaesthesiologists. Positive feedback from patients also helped these medical professionals win over surgeons and persuade them to use hypnosis during operations. As a result, the role of the anaesthesiologists in the operating theatre has been transformed, and their technical work has also taken on a human dimension. Ultimately, these medical professionals did not generally turn towards their peers to evolve: in other words, it was the very opposite of a transformation caused by external forces. They even distanced themselves from colleagues who rejected their choice.

Reinventing in relation-based professions

The researchers believe that the dynamic process identified here, which is based on both direct experiences with and feedback from people external to a particular occupation, could explain other voluntary professional reinventions. They cite, for example, certain district attorneys who have shifted their work away from incarcerating criminals to decriminalisation. It is possible that their direct experience of the impact of a trial on offenders, and feedback from the offenders, might have triggered a change in the way they relate to their work.

Likewise, if we simply replace the word “patient” with “client”, then we can see that these outcomes may apply to a huge mix of professions. Those working in occupations that involve regular contact with and feedback from consumers or other audiences may voluntarily transform their work by following the same dynamic. In these different contexts, the research emphasises the unknown and potential role of people outside a profession (i.e., clients) in how professionals may voluntarily reboot their work. The impact of these types of individual reinventions and their effects on transforming occupational communities more broadly are yet to be explored.

Find out more

Bourmault, N., & Anteby, M. (2023). Rebooting One’s Professional Work: The Case of French Anesthesiologists Using Hypnosis. Administrative Science Quarterly, 68(4). https://doi.org/10.1177/00018392231190300