Local Division of Labor in Rehabilitation Team Conferences

Abstract

This study investigates rehabilitation team members’ interactive accomplishments of their domains of work and responsibility in rehabilitation team conferences in Japan. A combination of membership categorization analysis and sequential analysis is adopted to systematically illustrate the situated productions of professional sense-making practices. Analysis focuses on the segment in which a physician asks a series of questions regarding a patient’s functional status and disability coded in the functional assessment record (FAR). A close examination of data shows that a physician does not always choose a respondent with his or her gaze when asking a question because s/he is continuously reading the FAR displayed on a computer screen. Despite this, a physician’s mention of a topic generates a professional’s domain of work and responsibility in a local division of labor which is used by members to assume who the relevant categorial respondent is. Further, members demonstrate these assumptions by shifting their gazes toward the computer screen, back to the document on the desk, and turning toward co-participants, thus embodying professional roles and responsibilities in situ. This study utilizes the analyst’s ethnographic understanding of the routines and division of labor at the rehabilitation ward as a resource to explicate professional sense-making practices, thus utilizing Garfinkel’s ethnomethodological studies of work. Together with sequential and categorial resources offered by Sacks, this study elucidates inferences and normative expectations which rehabilitation team members bring together to reproduce the endogenous logic of rehabilitation culture in actual occasions of the institutional life.