Association of Diabetes Care & Education Specialists

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Does professional alienation exist?

May 26, 2015

Recently, I resigned from a position which I held for over nine years. When I was thinking of the reason for my resignation, the only term I could think of was professional alienation. I have heard the terms parental and spousal alienation, but never “professional alienation," but somehow this was the only thing I could think of as a reason for leaving.

First, let me start by defining the term alienation. According to the Webster Dictionary, alienation is the “withdrawing or separation of a person’s affections from an object or position or former attachment.” Alienation is also known as estrangement.

In my previous employment, I felt my professional and clinical expertise were no longer of value to or respected by the company. Diabetes educators are invaluable commodities who are sought after by many employers, so I was baffled by the alienation I was experiencing. Surely I am not the only one who has experienced this phenomenon.

I define professional alienation as an estrangement by an employer or co-worker(s) in which a mutual respect for each other’s professional opinions is no longer in place. Collaboration among individuals in a team is central to successful care for patients. Once professional alienation occurs, I think there is little which can be done to repair the relationship.

What are your thoughts? Have you ever felt this way? How do you form relationships in your practice setting?


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  1. Jan 26, 2011

    Having worked in hospital based programs and in diabetes industry positions, it is my opinion that this (professional alienation) is endemic to hospital settings. CDE clinical teams in industy seem to develop very close bonds and are valued for their expertise. However, the model to determine value in hospitals is tied in with revenue production and it are those departments that can show the money, that get the value. Diabetes self management education has proven to improve clinical outcomes, decrease complications and keep people out of the hospital or decrease length of stays. But in a hospital revenue based mindset, this does not equate to increase income. Hospitals are very slow to change, whereas in industry, change is a given and is constant. Continuous improvement in industry is not just an exercise in meetings for the sake of meeting JACHO requirements, but is necessary to competative survival.
  2. Jan 08, 2011

    Very interesting point. I and other colleagues, unfortunately have encountered this all too often. It's a beautiful thing when things work out well between clinicians but in cases where is doesn't, the patient is the one that ultimately suffers.

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