Kangas H1
1University of Eastern Finland, Health Management Sciences, Kuopio, Finland
Background: The division of labour between physiotherapists (PT) and general practitioners (GP) in public healthcare in Finland has enhanced over 10 years. Nowadays PTs receive patients with musculoskeletal disorders, who have themselves assessed, that they need GP appointment. Direct access to PT is comparable to GP´s appointment. If necessary PT consults GP.
Purpose: The aim of this study was to describe how physiotherapists (PT) and general practitioners (GP) working in public healthcare perceive trust and the division of labour.
Methods: The case study was conducted in two municipal organizations. The study was examined in context of the treatment process for acute low back pain. The study sought answers to the following questions:
1) What are PTs´ and GPs´ views of trust and the division of labour?
2) Do PTs´ views of trust and division of labour differ from GPs´ views?
3) What are PTs´ and GPs´ views regarding a productive and unproductive division of labour.
The data was collected by interviewing PTs and GPs in 2013 (N=32) and 2016 (N=7). The data was analysed phenomenografically.
Results: According the views of PTs and GPs, healthcare professionals have poor knowledge and understanding about the competence of other healthcare professionals and the work they do. Trust was experienced important, but it rarely manifested in the social division of labour. The talk of trust was more likely rhetorical, because new roles in line with current division of labour had not been fully internalized. PTs´ and GPs´ views of trust did not differ. The most productive division of labour existed in healthcare units where the division of labour between different healthcare professionals was based on reciprocity and on working and learning together. Overlapping work was the greatest cause of an unproductive division of labour.
Conclusion(s): The social division of labour based on trust requires that PTs and GPs are committed to working, learning and developing issues together. Without shared commitment and understanding, the desired culture of social division of labour and productivity cannot be achieved. Patients should also be better informed about the new division of labour.
Implications: The results can be used in social and healthcare for developing a division of labour, additional training and management.
Keywords: Trust, social division of labour, public healthcare
Funding acknowledgements: The study was funded by The Finnish Work Environment Fundand Finnish Association of Physiotherapists.
Purpose: The aim of this study was to describe how physiotherapists (PT) and general practitioners (GP) working in public healthcare perceive trust and the division of labour.
Methods: The case study was conducted in two municipal organizations. The study was examined in context of the treatment process for acute low back pain. The study sought answers to the following questions:
1) What are PTs´ and GPs´ views of trust and the division of labour?
2) Do PTs´ views of trust and division of labour differ from GPs´ views?
3) What are PTs´ and GPs´ views regarding a productive and unproductive division of labour.
The data was collected by interviewing PTs and GPs in 2013 (N=32) and 2016 (N=7). The data was analysed phenomenografically.
Results: According the views of PTs and GPs, healthcare professionals have poor knowledge and understanding about the competence of other healthcare professionals and the work they do. Trust was experienced important, but it rarely manifested in the social division of labour. The talk of trust was more likely rhetorical, because new roles in line with current division of labour had not been fully internalized. PTs´ and GPs´ views of trust did not differ. The most productive division of labour existed in healthcare units where the division of labour between different healthcare professionals was based on reciprocity and on working and learning together. Overlapping work was the greatest cause of an unproductive division of labour.
Conclusion(s): The social division of labour based on trust requires that PTs and GPs are committed to working, learning and developing issues together. Without shared commitment and understanding, the desired culture of social division of labour and productivity cannot be achieved. Patients should also be better informed about the new division of labour.
Implications: The results can be used in social and healthcare for developing a division of labour, additional training and management.
Keywords: Trust, social division of labour, public healthcare
Funding acknowledgements: The study was funded by The Finnish Work Environment Fundand Finnish Association of Physiotherapists.
Topic: Primary health care; Primary health care; Musculoskeletal
Ethics approval required: No
Institution: University of Eastern Finland
Ethics committee: -
Reason not required: The Ethics Committee authorization was not necessary, because the study did not address the physical integrity of the investigators. The study based on investigators respect for self-determination, avoidance of damage, privacy and data protection.
All authors, affiliations and abstracts have been published as submitted.
