"Movement Expert" or "Machine Operator"? Physical Therapists'' Professional Autonomy and Care Practices in Taiwan

• Main Authors: Wei-Hong Chen, 陳韋宏
• Other Authors: 吳嘉苓
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/p2338u

碩士 === 國立臺灣大學 === 社會學研究所 === 107 === Why is there a huge gap between “movement expert” and “machine operator” in physical therapists’ practices? To analyze the professional practice of physical therapy, I use a variety of methods, including archival data analysis, in-depth interview, and participant observation. My research has three main points. First, Physical Therapy Act and National Health Insurance constitute the subordinate status in the medical division of labor; and the institutionally dominant position of physicians results from the superiority of diagnosis. Second, physical therapists’ assessment is a functional diagnosis which is different from the pathological diagnosis of physicians. Through the process of assessment, physical therapists can transform the patient’s physical problem into a functional problem. Third, I coin the concept of “choreographing work” to describe the clinical practice of physical therapy. This concept contains three aspects: arranging therapies in a sequence, adjusting the contents of therapies, and organizing therapeutic plans. An effective physical therapy relies on the adequate “choreographing work.” By this token, I argue we should problematize the definition of “therapy” to discover the interweaving process between care practices and social conditions. For policy implications, my findings call for reform of legal and medical systems to strengthen physical therapy. Two especially important changes would be to legitimize autonomy of physical therapists according to paramedical law and to have the payment system of National Health Insurance incorporate other professionals’ input besides the physician’s in the treatment for chronic pain.