Abstract
Objectives
To evaluate primary physiotherapist assessment and management of patients with musculoskeletal disorders in primary care, and to compare patient satisfaction with primary assessment by a physiotherapist or a general practitioner (GP).
Design
An observational, retrospective cohort study reviewing medical records, and a separate consecutive non-randomised study of patient satisfaction.
Setting
Primary healthcare centre.
Participants
Four hundred and thirty-two patients with musculoskeletal disorders, primarily assessed by a physiotherapist. Fifty-one of these patients primarily assessed by a physiotherapist and 42 patients assessed by a GP answered a patient satisfaction questionnaire.
Interventions
Primary assessment and management of patients with musculoskeletal disorders.
Main outcome measures
Data from medical records within 3-month after the visit, and patient satisfaction questionnaire.
Results
Eighty-five percent (367/432) of patients did not need to see a GP. Serious pathologies were found among the 6% (26/432) of patients who were referred to a GP by a physiotherapist, but no serious pathologies were found among the 9% (39/432) of patients who subsequently returned for a GP appointment for the same disorder. Patients assessed by a physiotherapist were more satisfied with the information received about their disorder and self-care than patients assessed by a GP. Patients also had higher confidence in the ability of physiotherapists to assess their disorder (P<0.002).
Conclusion
Physiotherapists can be considered primary assessors of patients with musculoskeletal disorders in primary care as few patients needed additional assessment by a GP, patients with confirmed serious pathologies were identified by the physiotherapists, and patients were satisfied with assessment by a physiotherapist.
Citation
Evaluation of physiotherapists as primary assessors of patients with musculoskeletal disorders seeking primary health care Maria Landén Ludvigsson, Paul Enthoven
Physiotherapy - June 2012 (Vol. 98, Issue 2, Pages 131-137, DOI: 10.1016/j.physio.2011.04.354)