Physiotherapy as part of collaborative and person-centered rehabilitation services: the social systems constraining an innovative practice
Objective: To explore the challenges with providing physiotherapy as part of collaborative and person-centered rehabilitation services.
Methods: This article reports on an all-day interactive workshop with eight focus group discussions where physiotherapists from six different professional settings participated. We draw on theories of institutional logics to interpret the results.
Results: Challenges were linked to: 1) Professional level: Services being based on what the profession can offer – not on users’ needs; 2) Organizational level: Rewarding efficiency instead of user outcomes; and 3) System level: Not knowing the other service providers involved or what they are doing.
Conclusion: An innovative practice was constrained by multilevel social systems: the professional logic shaping the perceived professional scope, the organizational logic shaping the understanding of what was expected in the organizational context, and a system logic within a biomedical paradigm. Transforming and transcending these social systems is needed to realize collaborative and person-centered practice.