In this blog, I am marrying reflections from my academic work on identity theory in politics and over 10 years’ involvement in healthcare professional regulation. I argue that identity is about belonging to a space and that regulation does play a part in forging a professional identity. Healthcare is used as my main focus, however, many of the assumptions below could easily apply to several other professional disciplines such as law and engineering.
Identity and space
Identity is about a feeling of belonging to a collective group. Many theorists (including Lefebvre, Foucault and Soja) considered space as a quality of social being and it is commonly believed that people are placed within a space, and that ‘they come from somewhere’. People tend to feel more comfortable within an environment that is familiar to them. Increasingly we have been making the distinction between place and space, where place refers to a physical location and geography, whereas space is not geographical but mental, imagined or virtual.
Traditionally, identities have been defined by people feeling that they belong to a group,thanks to a set of values or rules that are widely known and accepted by those joining. Those who do not belong to that specific space are considered to be intruders and outsiders. Traditional thinking asserts that space is a ‘solid place’ for its members, where they feel most comfortable and secure. Space is the safe, sheltered ‘home’.
Contemporary theories of space look at understanding space from a social perspective. Space is about social interaction, communication and networks. The feeling of belonging to an identity is strengthened through engaging and interacting, rather than adhering to a set of boundaries and rules. This applies to professional identity as people can feel part of a wider global professional group as opposed to just their local community and they tend to be more engaged through their professional networks as opposed to those setting ‘rules’ for them.
Identity and geography
When I applied this theory to politics, it became clearer that although traditionally one could argue that identity is about belonging to a geography (think nation state) and a set of rules and symbols (think flag, anthem, constitution) in contemporary theory, identity is about belonging to the so-called ‘Thirdspace’. This is a global space of connections (think social networking) with an imagined symbolism (mainly demonstrated through discourse and use of language and narrative).
Identity and belonging
Identities are not static. They evolve over time through interaction and social negotiation. The same can be said for professional identity: it evolves from being a student, to a young professional, to an experienced professional in a variety of roles, from academia to senior management in service delivery. It is important to also note that identities are hybrid and it will always be the case that an individual will feel they belong to more than one collective identity. Healthcare academics for instance belong both to their healthcare profession and to their academic role. It is important for the professional regulator to be mindful of that professional journey and be able to adapt its regulatory interventions accordingly.
Identity and symbolism
Professional identity involves the use of symbols: uniforms, badges, names and titles. However, with the evolution of space as argued earlier, these images of identity can be seen as traditionalist and what contemporary theory sees as symbolism are discourse, language and narrative in the expression of knowledge. In other words, you are not a professional because you are wearing the ‘badge’ or ‘uniform’ but because you portray professional values in your behaviour, expressing your knowledge and expertise and people trust you for that. I recognise this is still a largely contested area in many quarters of professional identity within and beyond healthcare.
The regulator’s role in this area is about ensuring the individual’s professional identity is recognised through their knowledge, critical thinking and expertise; registration and licensing can be the symbols of that. Regulators have found it hard though to spell out their role in identity symbolism. In the same way professional associations strengthen belonging through the ‘badge’ symbol, regulators may need to consider strengthening their narrative around the importance of registration as part of professional identity.
So where does regulation fit in identity theory?
Professional regulators set the rules and values of a profession through professional standards and codes of conduct. They thus create the professional space of identity for the professionals they regulate. Without them there is no national or global definition of a profession, which is why many unregulated professionals seek regulation and standards as a form of professional recognition.
Although regulators are the creators of identity in ‘designing and providing the space’ through a set of rules, they are not the ones who exercise those rules through ongoing interaction and social networking. Professional associations, colleges and societies play a significant role in social engagement while academic institutions are the first point of contact in the delivery of professional identity through teaching and learning.
Regulators remain at a distance from the exercise of professionalism. They are not as close to the individual as educators, employers and professional associations and because of that do not tend to interact socially in the way those other groups do. Many professionals see their regulators as an authority that takes negative action through fitness to practise processes as opposed to a positive instigator of professional identity. As a result, professionals align themselves to their professional group/association, feeling more supported by them, interacting with them more frequently and seeking their advice, as opposed to how they see their regulator – as the organisation which holds them to account. Regulators need to ask themselves: ‘What role in professional identity do they want to play in the future?’ They can choose between remaining at a distance, using authoritative language and being seen as the rule-setting body. Or they can change tack by articulating their role in professional identity formation. A balance needs to be struck between regulators continuing to demonstrate that they are about public protection, while strengthening their narrative around being an instigator of professional identity.
Dr Katerina Kolyva is the Executive Director of the Council of Deans of Health. She holds a PhD on European identity from the University of Kent.
Find out more about our research into professional identity and regulation or watch this short video about what our literature review revealed.