Evaluation of physiotherapists as primary assessors of patients with musculoskeletal disorders seeking primary health care.

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.