Boundary Objects in Medicine

Boundary objects play a huge role in medicine. Turf wars in medicine are about boundaries. Right now there’s a turf war going on in acupuncture because physical therapists are doing acupuncture by calling it something new, dry needling. It comes down to each state’s scope of practice law.

Physical therapists are purely working in natural science, matter oriented science. Acupuncturists, if true to what Oriental medicine is, work within an ancient paradigm that’s a cosmology of spiritual energy, a scheme of the body-mind-spirit outside of conventional western anatomy and physiology.

The idea of being bound includes our thinking and feelings. In the physical world a boundary is where your hand rests on the computer keyboard. Ergonomics is about the fit between boundaries. For instance what’s the angle and distance between your wrist and the computer’s edge. How’s your weight bearing on that surface edge? Is there full ease? Full comfort? Resistance, friction, or support? Are you getting any leverage?

If a relationship between boundaries is ergonomically sound then it’s harmonious and health promoting.  Where there is harmony there is support and even leverage. Support offers the potential for leverage. 

This article by researcher Kelly Owens is mentioned in my forthcoming book about the WISSH model. It’s a study about boundaries in medicine. The researcher uses two sciences that just happen to be part of the foundation of the WISSH model. She presents the concept of the boundary object. The WISSH model is such a boundary object. The model penetrates and unites diverse fields in medicine using the principles of true fit.

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