Abstract
Background:
Since its enactment in 1965, the Japanese Physical Therapist Act has been based on the framework of medical assistance under the direction of a physician and lacks legal support for preventive and public health activities in the community.
Purpose: This study identifies institutional issues in the current Physical Therapist Act and examines the need for an institutional design that supports the public health activities of physical therapists in the community.
Methods: Analysis of the articles of the system, published materials of the MHLW and the Japan Physical Therapists Association, previous studies, content analysis of newspaper case studies, and a case study (10 interviews, n=156 questionnaires) on the actual activities in the field were conducted. The collected data were organized and analyzed using qualitative analysis methods (KJ method) and descriptive statistics.
Results: Due to inadequacies in the legal system, voluntary community health activities conducted by physical therapists are legally precariously positioned, with limited expansion of job scope and reflection in the compensation system. Health classes, disaster relief, and industrial health activities, which are conducted as a matter of fait accompli, receive little institutional support. From the article analysis, seventy-three initiatives of physical therapists working outside the legal framework were identified, of which 68.5% did not receive continuous support from public funds.
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Conclusion: It is essential to develop an institutional basis for the participation of physical therapists in public health activities in the community. Revision of the current law is expected to clarify their roles and make their activities sustainable.
