The aim of this paper is to offer theoretical insights into the care of the self, which often initiates therapist-patient relationships in clinical practice. The reason is that when patients care about their health status, they are inclined to establish a therapeutic relationship with physical therapists. Hence, the care for self may bridge the world of the patient's private experiences and the world of the healthcare system together with its interventions, which is represented by the physical therapist In this framework, care means not only the patient's choice to undergo therapy but also his/her commitment to sustaining its effects in private life. This involves educational interventions by the physiotherapist who inscribes him/herself in his/her patients’ care of the self in order to alter their habits of physical exercise, diet, personal hygiene, body posture, etc. The argument in this paper is informed by the concepts of ethics developed by Michel Foucault and Richard Shusterman.
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For the sake of clarity, a short depiction of the position of physical therapist in Poland is in order, as the clinical case discussed in this paper is embedded in the Polish healthcare system. Physical therapists are the third largest group of medical practitioners in Poland, following physicians and nurses. The practice of physical therapists is defined as an independent medical profession and is regulated by the Act on the Profession of Physical Therapy of 25th September 2015. As termed by this law, physical therapists deliver health care services, including, among others, the functional diagnostics of the patient; the qualification, planning, and conduct of physical therapy, kinesiotherapy, and massage; physiotherapeutic prevention; research and scholarly pursuits; and the education of students. Like physicians, physical therapists are obligated to practice their profession with due care, abide by the principles of professional ethics, respect patients’ rights, and rely on the latest medical knowledge. It is their duty to collaborate with other professionals, in particular with physicians. In case of reasonable doubts regarding physical therapy prescribed by physicians, physical therapists have the right to request the physicians to justify their prescriptions. Physical therapists also have the right to refuse to provide such prescribed services, whereby they register the refusal in writing in medical records. Physicians are expected to supply physical therapists with complete information on the health status of the patients and give them access to the patients’ medical history. Similarly to physicians and nurses, physical therapists may start individual businesses and not only healthcare entities. Thus, they may for example be sole proprietors of individual physical therapy practice. Physical therapists are assembled in the Krajowa Izba Fizjoterapeutów (KIF; Polish Chamber of Physiotherapists), which represents the community of physical therapists, oversees the practice of the physical therapy profession, and works to uphold the proper standards of practice for the public interest Currently, there are about 71,000 physical therapists in Poland, 75% of whom are women (https://kif.info.pl/).
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