Introduction : Many occupational therapists (OTs) in Japan work in medical institutions. Among the 62,628 OTs registered with the Japan Occupational Therapists Association, 68.7% are employed at medical institutions. However, various challenges limit the ability of OTs to fully utilize their expertise in clinical practice.
Objectives : This study explored the challenges experienced by OTs in medical institutions and examined how the healthcare system influences these difficulties.
Methods : Data were collected between May and August 2022. The participants were OTs working in medical institutions who had experienced difficulties in practice. They were recruited through snowball sampling. Semi-structured interviews were conducted. The data were transcribed verbatim and analyzed qualitatively. The results were validated through member checking. This study was approved by the Ethics Committee of our institution.
Results : The difficulties identified were classified into four themes and three categories.
1. Constraints on occupational therapy practice imposed by the healthcare system
“Impact of the medical system on client interactions”
“Mismatch between expected outcomes and the therapeutic approach valued by OTs”
2. Lack of recognition of OT expertise
“Difficulty in understanding OT expertise owing to the everyday nature of occupations”
“Unclear professional identity owing to diverse role expectations”
3. Unmet occupational needs of clients
“Limitations owing to the prioritization of medical management”
Conclusion : This study suggests a mismatch between institutional expectations and OT expertise. Additionally, OT expertise is often underrecognized, and acute care settings prioritize disease management over patients’ occupational needs.