The professions in the West are undergoing unprecedented calls for greater accountability and efficiency in service delivery. This article links these changes to recent developments in institutional theory that emphasize shifting salience of technical over symbolic organizational environments. The analysis of the adaptations to these changes in French and British healthcare, Canadian education and US managerial consulting suggest that country-specific responses to neoliberal institutional pressures are highly path dependent. The article concludes by suggesting a research program for the future study of the cross-national responses of professional groups to neoliberal economic and political ideologies.
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