Physiotherapists,whether through international work or within the multicultural societies where manyclinicians live and work, are exposed to cultures that differ from their own. Clinical interactions in across-cultural situation highlight the complexities of culture in practice. Three specific areas are highlightedand explored: the culture of physiotherapy practice; cultural competencewithin the profession; and the culture of the employing organisation. Culturalcompetence is further developed and analysed at three levels: awareness of different cultures; acceptance of multiple truths and knowledge; and collaboration to avoid the potentially destructive power ofthe dominant culture. Current literature allows a theoretical framing of the issues, which indicates that physiotherapy should be considered as a cultural practice. The investment of western concepts such as autonomy and individualism, as well as the objectification inherent within the medical model, lead to significant dilemmas in the cross-culturalcontext. However, a significant lack of detailed ethnography of practice is also a weakness in the debate. Resultant areas for future research are highlighted.
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