Introduction

Tasks and professions change over time, and theorists of professions such as Abbott (1988) emphasise that the development of a profession always takes place both through interaction and in conflict with adjacent professions. The tasks and fields of responsibility of a profession are the result of negotiations, struggles and border disputes with other professions. In the case of healthcare providers, the needs of different client groups and the state's wish for control and management are also part of the picture. In order to understand the development of a profession, it must be studied within an interacting system of professions. Task control – jurisdiction, according to Abbott – is in this connection the key to understanding.

In this chapter, we discuss the history of physiotherapy in Norway, which is a case that illustrates the significance of Abbott's perspective. It is first and foremost characterised by disputes related to the division of work and responsibility between physicians and physiotherapists, that is, jurisdictional borders concerning physiotherapists’ practice and knowledge base. These disputes are closely connected to the struggle for acceptance by society, primarily expressed in the physiotherapist group's efforts to become part of the country's health services and to achieve public authorisation. A central concern with regard to physiotherapists’ practice and knowledge base has been to have the state – not the medical profession – take control of the education of physiotherapists.

From the very beginning, in the early 20th century, physiotherapists – working in private institutes and with home visits – depended on physicians’ acceptance and goodwill for a secure livelihood. Moreover, for 70 years physicians owned and ran the education of physiotherapists. As time passed, and as physiotherapists struggled for permanent positions in what became the country's welfare project, physiotherapy gradually developed as part of the state apparatus. Thus, and as we will show, the state should be regarded as a partner in strengthening the autonomy of Norwegian physiotherapists. This is the case with respect to crucial formalities, via legislation, as well as therapists’ freedom at the workplace, for example, to choose new and relevant tasks and to broaden their client base. As to their training, the education of physiotherapists has for several decades been organised by the state.