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Much of the research on professions in the field of healthcare focuses on standard bodies of knowledge, jurisdictional claims, state regulations, and professional closure, which are characteristics of professions like medicine. However, new notions such as client-based professionalization, professional fluidity, and connective professionalism have recently emerged in the sociology of professions literature. This article suggests a new perspective on alternative paths of professionalism at the margins of the healthcare system, drawing on the case of spiritual caregivers. Semi-structured in-depth interviews were conducted with 15 Israeli spiritual caregivers. The interviewees presented themselves as professionals by describing characteristics resembling the new notions of professionalism: the centrality of the patient, the fluid nature of the practice of spiritual care, and their connectivity with other healthcare practitioners. New notions in the sociological study of professions can help us understand alternative paths of professionalism at the margins of the healthcare system and to characterize the practitioners in these margins. This could contribute to a better understanding of the new sources of gaining legitimacy in the healthcare system to the benefit of patients, medical practitioners, other staff members, and medical institutions at large.

Recent approaches to professions and professional identity question the premise that professionalization is the ultimate generator of status, showing that the classical model of professionalization does not always coincide with workers’ creative construction of professionalism and professional dignity. Extending these approaches, and focusing on workers’ identity discourse, this study examines how private child-care workers in Israel claim professional status precisely by avoiding formal professionalization and promoting a counter-professionalization ethos. Drawing on field observations and interviews, we analyze nannies’ tacit occupational community dynamics, by which they establish professional rules and boundaries and discursively construct a respected professional self. Their identity-talk reveals a vocational self-imaging based on personal charisma, one that resists training and credentials. This vocational self-imaging allows rebuttal of the nanny stereotype as a low-class uneducated workforce, associated with their ethnicized backgrounds, by symbolically transforming it and using it as a high-value identity resource. This counter-professionalized identity-talk prevails despite the social distinction between senior and junior nannies. Thereby, nannies gain professional status while the professionalization of child care is rejected. The analysis of these cultural dynamics provides a stronger perspective on professions as spheres of identity construction—specifically those ranked lower as unskilled labor—and on workers’ agency behind their ostensibly passive compliance with under-professionalization.

In this comment to Noordegraaf’s ‘Protective or connective professionalism? How connected professionals can (still) act as autonomous and authoritative experts’, we argue that Noordegraaf has contributed significant insights into the development of contemporary professionalism. However, we argue for a less binary and more complex view of forms of professionalism, and for finding ways of understanding professionalism grounded in a relational view of everyday professional work. The first section (by Johan Alvehus) suggests that Noordegraaf’s ‘connective professionalism’ is primarily about new ways of strengthening professionalism’s protective shields by maintaining functional ambiguity and transparent opacity around professional jurisdictions. The second section (by Amalya Oliver and Netta Avnoon) argues for viewing professionalism on a range of protection–connection and offers an approach for understanding how connective and protective models co-occur. Both commentaries thus take a relational, dynamic, and somewhat skeptical view on the reproduction and maintenance of professionalism.