Becoming a practice profession: a genealogy of physiotheraphy's moving/touching practices

This research responds to gaps in the literature about the evolution of physiotherapy practice and to uncertainties emerging from within physiotherapy about its professionalism and practice. It aimed to generate a theoretically informed understanding of the tensions present in contemporary physiotherapy practice by producing an embodied account of the process of becoming a practice profession. The research aim was achieved by a genealogical study of existing literature, documentary data from physiotherapy’s qualifying curricula and oral accounts of practice generated by depth interviews with physiotherapists who qualified during the 1940/60s. These data were subject to a Foucauldian discourse analysis and a phenomenological analysis to explore the events, discourses and actions shaping physiotherapy practice over time. Unlike existing historic accounts that trace the evolution of physiotherapy’s professional identity, this research prioritises the bodies doing physiotherapy over time so offers a fresh perspective on physiotherapy as a practice and as a profession. From a ‘doing’ perspective, professionalism ceases to be an acquisition that is externally bestowed and becomes a dynamic process of experiencing/producing autonomous problem-solving in practice. Physiotherapy’s professional practice can be traced back to the 1945 curriculum. It was enacted through the integration of physiotherapy movement/touch and by the discipline of movement, which generated autonomous problem-solving practices that cut across ward/disease boundaries established by medicine from the 1950s onwards. While still subject to medical supervision, physiotherapy’s movement/touch crossed the division of labour to develop capacity to produce diagnosis-inference-treatment once its technical autonomy was recognised in 1977. Once free of medicine, physiotherapy’s professional practices multiplied to provide moving/touching solutions for an increasing variety of movement disorders. My research complements the existing (disembodied) critical histories of physiotherapy as a profession and demonstrates the value of embodiment as a lens for tracing movement in physiotherapy’s professional identities and practices over time. It adds to sociological understanding of the organisation of healthcare occupations and practices by offering an account of a body that is a moving part of a division of labour organised around the dominant profession of medicine