1,721,083 research outputs found
The allied health professions: a sociological perspective
No full textThe allied health professions have gained legitimacy through the pursuit of research evidence and the standardisation of practice. Yet there remains very little analysis or understanding of these professions. Adopting theory from the sociology of health professions, this book explores the sociological, economic, political and philosophical pressures that have shaped the professions. Drawing on case studies and examples from occupations including optometrists, occupational therapists and physiotherapists to emerging vocations, including pedorthists and allied health assistants, the book offers an innovative comparison of allied health professions in Australia and Britain. By telling the story of their past, the book prepares the allied health professions for a new and different future
Dynamic professional boundaries in the healthcare workforce
No full textThe healthcare professions have never been static in terms of their
own disciplinary boundaries, nor in their role or status in society.
Healthcare provision has been defined by changing societal
expectations and beliefs, new ways of perceiving health and illness,
the introduction of a range of technologies and, more recently, the
formal recognition of particular groups through the introduction
of education and regulation. It has also been shaped by both interprofessional
and profession-state relationships forged over time.
A number of factors have converged that place new pressures on
workforce boundaries, including an unmet demand for some
healthcare services; neo-liberal management philosophies and a
greater emphasis on consumer preferences than professional-led
services. To date, however, there has been little analysis of the
evolution of the workforce as a whole. The discussion of workforce
change that has taken place has largely been from the perspective
of individual disciplines. Yet the dynamic boundaries of each
discipline mean that there is an interrelationship between the
components of the workforce that cannot be ignored. The purpose
of this paper is to describe four directions in which the existing
workforce can change: diversification; specialisation and vertical
and horizontal substitution, and to discuss the implications of
these changes for the workforce
Sociology of the professions: what it means for podiatry
No full textBackground: The health professions have progressed and evolved considerably over the last few decades in response to demographic, technological, societal and political changes. They continue to do so as the volume and complexity of population health needs steadily increase. Role boundary expansion is among the key changes to the health professions, including podiatry to meet demand. Nonetheless podiatry's role boundary expansion has not been achieved swiftly or without resistance from neighbouring and dominant professions. This paper seeks to explain the nature of this resistance with respect to the sociology of the professions literature and to shed light on some of the factors and processes at play when role boundary changes arise in health care. Discussion: Six of the most contemporaneously relevant sociology of the professions theories are summarised: Taxonomic, Marxian, Bourdieusian, Foucauldian, Boundary Work and Neo-Weberian paradigms. Conclusion: This review highlights that some paradigms are more relevant than others in the current socio-political landscape. It also illustrates that there is a common theme underlying each approach to defining the professions and their boundaries: competition. This may help health professionals, including podiatrists, to understand and manage the challenges and resistance experienced when professions attempt to expand role boundaries to meet increasing and changing population health needs.</p
Interprofessional role boundaries in diabetes education in Australia
No full textDiabetes presents a challenge to healthcare services worldwide. Diabetes educators work with individuals and communities to reduce the impact of diabetes. In Australia, diabetes educators derive from one of several primary qualifications including nursing, medicine or a specified allied health background, and have an accredited postgraduate qualification in diabetes education. The peak professional body, the Australian Diabetes Educators Association (ADEA), promotes equivalence of all diabetes educators in terms of their scope of practice. However, in practice, there is evidence of inequities, particularly between those from nursing and allied health backgrounds. This paper uses a neo-Weberian lens to explore the interprofessional role dynamics of a ‘postprofessional’ group of practitioners, who adopt a common role and title to create a professional identity at post-qualifying level. Data were collected via individual interviews with 19 stakeholders and analysed using an abductive template approach. Differential role boundaries between nurse and allied health diabetes educators were established and reinforced in several ways. Diabetes education is considered a sub-specialty of nursing only; access to education and credentialing has been restricted for allied health; reinforcement of professional stereotypes and perceived professional values; and perceived legislative differences in access to medication management for nurse and allied health diabetes educators
Contested professional role boundaries in health care: a systematic review of the literature
No full textAcross the Western world, demographic changes have led to healthcare policy trends in the direction of role flexibility, challenging established role boundaries and professional hierarchies. Population ageing is known to be associated with a rise in prevalence of chronic illnesses which, coupled with a reducing workforce, now places much greater demands on healthcare provision. Role flexibility within the health professions has been identified as one of the key innovative practice developments which may mitigate the effects of these demographic changes and help to ensure a sustainable health provision into the future. However, it is clear that policy drives to encourage and enable greater role flexibility among the health professions may also lead to professional resistance and inter-professional role boundary disputes. In the foot and ankle arena, this has been evident in areas such as podiatric surgery, podiatrist prescribing and extended practice in diabetes care, but it is far from unique to podiatry. MethodsA systematic review of the literature identifying examples of disputed role boundaries in health professions was undertaken, utilising the STARLITE framework and adopting a focus on the specific characteristics and outcomes of boundary disputes. Synthesis of the data was undertaken via template analysis, employing a thematic organisation and structure. ResultsThe review highlights the range of role boundary disputes across the health professions, and a commonality of events preceding each dispute. It was notable that relatively few disputes were resolved through recourse to legal or regulatory mandates. ConclusionsWhilst there are a number of different strategies underpinning boundary disputes, some common characteristics can be identified and related to existing theory. Importantly, horizontal substitution invokes more overt role boundary disputes than other forms, with less resolution, and with clear implications for professions working within the foot and ankle arena. <br/
Diabetes educator role boundaries: a documentary analysis
Get PDFBackground: Diabetes educators provide self-management education for people living with diabetes to promote optimal health and wellbeing. Their national association is the Australian Diabetes Educators Association (ADEA), established in 1981. In Australia the diabetes educator workforce is a diverse, interdisciplinary entity, with nurses, podiatrists, dietitians and several other health professional groups recognised by ADEA as providers of diabetes education. Historically nurses have filled the diabetes educator role and anecdotally, nurses are perceived to have wider scope of practice when undertaking the diabetes educator role than the other professions eligible to practise diabetes education. The nature of the interprofessional role boundaries and differing scopes of practice of diabetes educators of various primary disciplines are poorly understood. Informed by a documentary analysis, this historical review explores the interprofessional evolution of the diabetes educator workforce in Australia and describes the major drivers shaping the role boundaries of diabetes educators from 1981 until 2017.Methods: This documentary analysis was undertaken in the form of a literature review. STARLITE framework guided the searches for grey and peer reviewed literature. A timeline featuring the key events and changes in the diabetes educator workforce was developed. The timeline was analysed and emerging themes were identified as the major drivers of change within this faction of the health workforce.Results: This historical review illustrates that there have been drivers at the macro, meso and micro levels which reflect and are reflected by the interprofessional role boundaries in the diabetes educator workforce. The most influential drivers of the interprofessional evolution of the diabetes educator workforce occurred at the macro level and can be broadly categorised according to three major influences: the advent of non-medical prescribing; the expansion of the Medicare Benefits Schedule to include rebates for allied health services; and the competency movement. Conclusion: This analysis illustrates the gradual movement of the diabetes educator workforce from a nursing dominant entity, with an emphasis on interprofessional role boundaries, to an interdisciplinary body, in which role flexibility is encouraged. There is however, recent evidence of role boundary delineation at the meso and micro levels
Achieving professional status: Australian podiatrists’ perceptions
No full textBackground: this paper explores the notion of professional status from the perspective of a sample of Australian podiatrists; how it is experienced, what factors are felt to affect it, and how these are considered to influence professional standing within an evolving healthcare system. Underpinning sociological theory is deployed in order to inform and contextualise the study.Methods: data were drawn from a series of in-depth semi-structured interviews (n = 21) and focus groups (n = 9) with podiatrists from across four of Australia's eastern states (Queensland, New South Wales, Victoria and Australian Capital Territory), resulting in a total of 76 participants. Semi-structured interview schedules sought to explore podiatrist perspectives on a range of features related to professional status within podiatry in Australia.Results: central to the retention and enhancement of status was felt to be the development of specialist roles and the maintenance of control over key task domains. Key distinctions in private and public sector environments, and in rural and urban settings, were noted and found to reflect differing contexts for status development. Marketing was considered important to image enhancement, as was the cache attached to the status of the universities providing graduate education.Conclusion: perceived determinants of professional status broadly matched those identified in the wider sociological literature, most notably credentialism, client status, content and context of work (such as specialisation) and an ideological basis for persuading audiences to acknowledge professional status. In an environment of demographic and workforce change, and the resultant policy demands for healthcare service re-design, enhanced opportunities for specialisation appear evident. Under the current model of professionalism, both role flexibility and uniqueness may prove important
Non-medical prescribing in Australasia and the UK: the case of podiatry
Get PDFBackground: the last decade has witnessed a rapid transformation in the role boundaries of the allied healthprofessions, enabled through the creation of new roles and the expansion of existing, traditional roles. A strategyof health care ‘modernisation’ has encompassed calls for the redrawing of professional boundaries and identities,linked with demands for greater workforce flexibility. Several tasks and roles previously within the exclusive domainof medicine have been delegated to, or assumed by, allied health professionals, as the workforce is reshaped tomeet the challenges posed by changing demographic, social and political contexts. The prescribing of medicinesby non-medically qualified healthcare professionals, and in particular the podiatry profession, reflects thesechanges.Methods: using a range of key primary documentary sources derived from published material in the publicdomain and unpublished material in private possession, this paper traces the development of contemporary UKand Australasian podiatric prescribing, access, supply and administration of medicines. Documentary sourcesinclude material from legislative, health policy, regulatory and professional bodies (including both State and Federalsources in Australia).Results: tracing a chronological, comparative, socio-historical account of the emergence and development of‘prescribing’ in podiatry in both Australasia and the UK enables an analysis of the impact of health policy reformson the use of, and access to, medicines by podiatrists. The advent of neo-liberal healthcare policies, coupled withdemands for workforce flexibility and role transfer within a climate of demographic, economic and social changehas enabled allied health professionals to undertake an expanding number of tasks involving the sale, supply,administration and prescription of medicines.Conclusion: as a challenge to medical dominance, these changes, although driven by wider healthcare policy,have met with resistance. As anticipated in the theory of medical dominance, inter-professional jurisdictionaldisputes centred on the right to access, administer, supply and prescribe medicines act as obstacles to workforcechange. Nevertheless, the broader policy agenda continues to ensure workforce redesign in which podiatry hasassumed wider roles and responsibilities in prescribing
Contested role boundaries and professional title: implications of the independent review of podiatric surgery in Australia
No full textIntroduction: in October 2023, the Podiatry Board of Australia commissioned an independent review of the regulation of podiatric surgery in Australia, with a remit to re-evaluate the regulatory framework, identify any risks to patient safety and recommend improvements to public protection. It reported in March 2024 and set out 14 key recommendations. The review was prompted by a number of complaints about podiatric surgeons but also reflected calls for reform by the medical profession and several critical media reports. This paper sets out to examine the review report, alongside the concerns of the medical profession and the media articles expressed within it, through the lens of an established sociological framework focused on interprofessional conflict and the contested use of professional titles.Methods: as a review rather than the research paper, the Independent Review of Podiatric Surgery (the ‘Paterson Report’) served as data for the sociological analysis, adopting a Neo-Weberian and Bordieuan framew
- …
