Extended scope practitioner (physiotherapist) as first point of contact for musculoskeletal conditions in primary care

Monteith, Will; Turner, Helen; McRitchie, C.; Downie, Fiona

doi:10.1016/j.physio.2018.11.069

Cited by 2 publications

(3 citation statements)

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“…For this reason, there is a need to further (and quickly) transform the training and education of physiotherapists to focus on disease prevention and health promotion as well as functioning at a primary level of care. The broadening of the role of physiotherapy in South Africa, whether by advancing the scope (Fennelly et al 2020 ) or extending it (Bastiaens, Barten & Veenhof 2021 ; Monteith et al 2019 ), should consider the regulator’s ethical rules. Physiotherapists should also be proactive and collaborate with other health care professionals to dismantle the unprogressive professional hierarchy.…”

Section: Discussionmentioning

confidence: 99%

Strategies to integrate physiotherapists into primary health care in South Africa

Narain

Mathye

2023

South African Journal of Physiotherapy

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Background: Health services are inaccessible in low-income countries. The National Health Insurance (NHI) bill, linked to primary health care (PHC), was introduced in South Africa to improve access to health services. Physiotherapists contribute to healthcare and improve individuals’ health status across their lifespan. The South African healthcare system has many challenges: physiotherapists mostly practising at secondary and tertiary levels of care; a shortage of physiotherapists in the public health systems and rural areas; the omission of physiotherapy in health policies.Objectives: To explore strategies to integrate physiotherapy services in PHC settings in South Africa.Method: Our study used a qualitative, exploratory and descriptive approach to collect data from nine doctorate physiotherapists at South African universities. Data were thematically coded.Results: The themes are to (1) improve societal knowledge of physiotherapy, (2) ensure policy representation of the profession, (3) transform physiotherapy education, (4) broaden the role of physiotherapy, (5) eradicate professional hierarchy and (6) increase the physiotherapy workforce.Conclusion: Physiotherapy is not well known in South Africa. Physiotherapy is needed to feature in health policies to transform education focussing on disease prevention, health promotion and functioning in PHC. Broadening physiotherapy roles should consider the regulator’s ethical rules. Physiotherapists should proactively collaborate with other health professionals to dismantle professional hierarchies. Without addressing the urban-rural, private-public divide, the physiotherapy workforce cannot improve, to the detriment of PHC.Clinical implication: Implementing the suggested strategies may facilitate physiotherapy integration into PHC in South Africa.

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Section: Discussionmentioning

confidence: 99%

Strategies to integrate physiotherapists into primary health care in South Africa

Narain

Mathye

2023

South African Journal of Physiotherapy

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“…Authors reported that fewer than 1% of patients required review by a primary care physician after the advanced practice physiotherapy assessment and initial treatment. A significant reduction of the referral rate to orthopaedic surgeons was also observed and 86% of the referrals to surgeons were considered appropriate (compared with only 31% of referrals considered appropriate in usual care) [63,[65][66][67]. in terms of health care costs, the study which included cost measurements of the episode of care of 9696 patients reported significant differences in favour of the advanced practice physiotherapy model compared with primary care physician-led usual medical care with reference to direct and also indirect costs (£159,693 for consultations and care in the advanced practice physiotherapy model compared with £211,227 with primary care physician-led care) [63].…”

Section: Advanced Practice Physiotherapy In Primary Carementioning

confidence: 93%

“…At these centres, advanced practice physiotherapists assess and diagnose patients, prescribe blood and imaging tests, and can perform medical therapeutic interventions such as soft-tissue and joint injections for patients with various MSds [53,62]. The impact of these centres has been reported in 1 prospective observational study by Monteith et al [63] and 1 retrospective observational study by downie et al [64]. Authors reported that fewer than 1% of patients required review by a primary care physician after the advanced practice physiotherapy assessment and initial treatment.…”

Section: Advanced Practice Physiotherapy In Primary Carementioning

confidence: 99%

New models of care integrating more autonomous roles for physiotherapists: a narrative review

Demont¹,

Kechichian²,

Davergne³

et al. 2022

Physiother Quart.

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With the increased prevalence of non-communicable diseases and chronic disorders, including musculoskeletal disorders, access to care is limited in many health care systems and new multidisciplinary collaborative models of care have now been implemented in several countries in an effort to improve access to care. The paper aimed to describe the characteristics and present relevant evidence supporting different models of care that integrate physiotherapists as primary or secondary care practitioners for the management of patients with non-communicable diseases or chronic disorders. on the basis of a literature review up to August 2020 in 4 major bibliographical databases, we searched for studies of any design, including systematic reviews with or without meta-analysis and position statements, that were related to direct access physiotherapy and advanced practice physiotherapy models of care. The impact of direct access physiotherapy and advanced practice physiotherapy models of care is presented in terms of clinical outcomes, patient satisfaction, health care resource use and costs. These models appear to provide equal or better outcomes in terms of access to care, quality of care, and patients' satisfaction. The strength of the evidence is variable, and outcomes vary depending on clinical settings, roles of physiotherapists, and characteristics of patients. This review highlights that these enhanced roles for physiotherapists, such as diagnosing, ordering diagnostic tests, or referring patients to physicians, in both primary and secondary care settings, are beneficial and may help optimize patients' journey by providing earlier access to effective and efficient services compared with physician-led usual care models.

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Extended scope practitioner (physiotherapist) as first point of contact for musculoskeletal conditions in primary care

Cited by 2 publications

References 0 publications

Strategies to integrate physiotherapists into primary health care in South Africa

Strategies to integrate physiotherapists into primary health care in South Africa

New models of care integrating more autonomous roles for physiotherapists: a narrative review

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