Abstract
"Professionals and professional organizations are important actors to focus onto, in order to better understand how complex processes of institutional change unfold. I start from the consideration that a better integration between the sociology of profession and new institutional theory is desirable. With the subsequent chapter I aim to show how exploiting the synergies deriving from using these two powerful theoretical frameworks we can advance in our understanding how professionals impact the way in which take- for-granted practices, organizational setting and inter-personal arrangement are defined and redefined in a context of institutional change. With that purpose in mind, in chapter two we analyze institutional change at the field level, focusing on the emergence of a new profession, the professional winemaker, in the Italian wine industry. We find that, following local and international pressures, incumbent wineries brought in non-competing new entrants, i.e., professional winemakers, to access key resources. In the process of defining their professional jurisdiction and their network of relations, these new entrants brought new material skills, which accelerated the transformation of the field. Our setting is the Italian wine industry between 1997 and 2006 and our data cover 74,000 wines, 2,000 winemakers and 3,000 wineries. We focus on the evolution of higher status denomination wines (DOCG), and compare the network of already institutionalized DOCG producers with the network of emerging DOCG producers to understand the impact of the professional winemakers and their role in the spreading of the barrique oak barrel. Our findings contribute to institutional and professions literatures, unveiling how the emergence of a new profession, together with its practices and skills, can accelerate the pace of institutional change in a field. In chapter three, I concentrate on the process of organization and re-organization of an established profession: the general practitioner. I investigate how a pioneering group of professionals foster change in a particularly resilient Institutional field: the Italian Primary Healthcare system. The in-depth qualitative analysis composed of 81 interviews conducted in 2014 and 2015, and 417 documents covering a 40 years' period, show how these groups of general practitioners, first created and then utilized their professional organization – the cooperative – to re-establish their relevance in the field. Three macro-processes are proposed to capture the proactive role of professionals in the field: Serving their community, which connected their original motivations; and, innovating and diffusing, which related to the institutionalization of the new organizational model throughout the field. In chapter four, I focus on inter-professional collaboration and, especially, how field level institutional logics permeate professional service firms. I argue that the different mix or constellation of logics influence, impede or favor inter-professional collaboration in multi-professional organizations. Drawing on a case study focused on an experimental Italian medical home managed by a cooperative of physicians, I analyzed 36 semi-structured interviews with the different professionals who inhabited the medical home during its 18 months' project duration. The results of this analysis point to the presence of a specific logic mix, composed of the Professional Logic and two blended logics (Corporate for Professional Logic and Market for Community Logic), which deeply influenced the collaboration pattern inside the multi-professional setting. I conclude highlighting how these three distinct empirical studies answer the overarching research question guiding this study and how generally this dissertation contribute to our theoretical understanding of the roles and effects of professionals and professional organizations in processes of institutional change."