Different kinds of work

What does work mean to physiotherapists?

A recent article in the journal Qualitative Health Research highlighted some of the different meanings of work for 12 women with cancer (link).

One of the most interesting findings from the study was that there were many different kinds of work experienced by the women, including “illness work, body work, identity work, everyday work, paid employment and/or the work of maintaining income, and coordination work”.

When you include things like the work of breathing and professional work, you have a concept that is both at the heart of physiotherapy practice, and yet almost entirely un-theorised.

Work has a particularly interesting history, because it didn’t exist, in the way we know it today, until the Industrial Revolution.

Prior to the 18th century, most people lived in small, rural communities where daily tasks were shared amongst people with far less demarcation between people’s roles. Childcare, food production, worship and other communal activities were undertaken by those who were available. Delineations between things like mens’ and womens’ work, manual trades and childcare only really emerged when societies grew large enough to allow for new forms of work.

Since then, sociologists have poured over the different kinds of work and, in some situations, created new ways of categorising and dividing up human labour (see, for instance, the functionalist work of people like Emile Durkheim and Talcott Parsons).

Understanding work in healthcare becomes important when it allows us to differentiate between clinicians and consumers, and affords value to some kinds of labour (expert, trained, officially recognised), at the expense (literally) of others.

As is well known, women have been a particular victim of this distinction, taking on the majority of the caring work in society without economic or social recognition.

This arbitrary distinction perpetuates the myth that some kinds of work (be it physical or intellectual) should be rewarded economically and socially, and others not. And this really struggles under the weight of complexity that comes with a significant health event like cancer or chronic illness.

Given that physiotherapists are central in the act of recovery and rehabilitation, and that it is a female dominated profession, it is perhaps surprising that so little of attention has been given to the different meanings we give to the idea of work.

There has been a lot of discussion in recent years about the changing nature of work; the impact of automation and technological innovation; and the increasing precarity of work for many of our young people today. These conversations have a direct impact on the nature of health work – both for clients/patients, and for clinicians.

It would be nice to see more attention given to the meaning of work for physiotherapists who have benefitted for so long from an arbitrary distinction that is now becoming increasingly difficult to sustain.