Fractured: A Study of Intraprofessional Paramedic Dynamics on Professionalization in Ontario, Canada

Abstract

Despite documented threats and challenges to professional workers, occupations and professions of all kinds remain motivated to pursue professionalization projects aimed at improving their social location. However, to drive professionalization from within an occupation means resisting or adapting to a variety of pressures from other professions, managerial organizations, and neoliberal government agendas. Emerging research has highlighted that some professions can adapt to or resist these pressures, while others falter. How intraprofessional dynamics impact professionalization in these conditions is less understood. This thesis aims to address this gap through a qualitative case study of paramedic professionalization in Ontario, Canada. Data from interviews with paramedic leaders and a document analysis were used to examine how intraprofessional dynamics have impacted paramedic professionalization. Drawing on various theoretical and conceptual threads from neo-Weberianism and neo-institutional theory, each empirical chapter examines a topic related to professionalization: regulation, higher education, and expansions in work. The findings of each chapter reveal widespread intraprofessional stratification, and at times, conflict. Some paramedic leaders are driven to improve paramedic status, recognition, and autonomy, however, must do so in increasingly flexible, collaborative, and subtle ways. While intentional stratification is at times pursued as an innovative strategy in response to organizational and government pressures and mandates, it comes at a cost to professional unity. Others are resistant or skeptical of professionalization that may change the physical, boots-on-the-ground ethos of frontline paramedics. The finding of this thesis sheds light on the intraprofessional dynamics of an understudied occupation and how they relate to contemporary scholarly debates about the processes and outcomes of contemporary professionalization.