Professional Change and Identity in Contemporary Physiotherapy: A Six-Domain Conceptual Framework.

Abstract

Background and purpose: Contemporary physiotherapy is often described as evidence-informed, person-centered, and biopsychosocial. These descriptions can imply a break with earlier practice, although some commitments have longer histories. This paper proposes a framework for examining professional change and its implications for professional identity.

Methods: This single-author conceptual analysis draws on a purposive reading of historical, sociological, critical, and professional literature. The professional maturation hypothesis is a working proposition: change may strengthen an enduring commitment or alter a foundational assumption. Contrasting examples inform six provisional domains; we did not conduct a systematic review or empirical validation.

Results: The domains are understanding of the body and health, knowledge, professional role, therapeutic relationships, therapeutic purpose, and organization of care. Within each domain, the framework distinguishes maturation (better evidence or enactment), consolidation (institutional support), rebranding (new language without demonstrated substantive change), and rupture (a consequential shift in foundational assumptions). These interpretations may coexist.

Discussion: The framework helps clinicians, educators, researchers, and professional organizations assess what has changed, where, to what extent, and with what consequences. Its intended use is context-specific reflection and cross-national inquiry, not classification of countries along a universal trajectory. The framework remains provisional and unvalidated.