Professional work and the professionals that do it have faced increasing pressure to submit to markets in order to reform overall service delivery and increase efficiency (see Hanlon 1999). The relatively new emphasis on market efficiency has occurred in tandem with several other cross-cutting developments - wellpublicised financial scandals involving new entrepreneurial roles for professionals (exemplified by Enron and Parmalat) and the cultural shifts accompanying ‘the end of expertise’ (Nichols 2017) and its most recent manifestations, the Brexit vote and the election in the United States of Donald Trump. These trends are part of a wider trend towards growing radical reflexivity among consumers and cultural fragmentation associated with the spread of postmodernism, with the accompanying scepticism of grand narratives and the coercive component of expert claims. These cross-cutting trends leave individual consumers and clients adrift in a sea of contradiction - mistrustful of free markets, yet mistrustful of experts and their grand narratives. This existential dilemma provides several opportunities for revitalised professions to stand in the breach between the global and the personal. I will start this chapter with a look at recent developments then tie those developments to broader long-term trends that have changed the nature of professional work.