Making breathing your business: enterprising practices at the margins of orthodoxy

Abstract

Over the last 30 years there has been a gradual but nonetheless significant shift in the political economy of healthcare in developed countries. The health reforms that have accompanied this shift have had a significant impact upon medicine, nursing and a number of other orthodox health professions, but to date, little work has been done to explore the changing nature of physiotherapy practice. This study draws on Foucault's notion of governmentality to explore the enterprising practices of a new physiotherapy clinic established in Auckland, New Zealand. Drawing on a critical history of respiratory physiotherapy, which had previously been firmly anchored within the public health sector, we show that the actions and practices of the clinic's staff are testing the margins of orthodox physiotherapy practice and exploring the new market possibilities offered by consumer demand for optimal health. The study explores how the physiotherapists at the clinic are problematizing the practices, clinical spaces and clientele associated with orthodox practice, and, most notably, commodifying breathing, to create a space within which it is possible to think about physiotherapy otherwise. This study builds on the instability now surrounding the orthodox health professions and asks if exemplars like that offered in this article provide some meaningful insights into the future for healthcare practice.