Referring doctors' perspectives about Physiotherapy management for chronic musculoskeletal pain

Abstract

Introduction: Patients diagnosed with chronic disabling musculoskeletal pain have better health outcomes and higher levels of satisfaction with Physiotherapy management. A pilot study conducted by the authors found that doctor’s referral to Physiotherapy treatment could have affected the satisfaction of the patients towards Physiotherapy management. Aims: The aim of the current study was to look into the perspectives of referring doctors (physicians and surgeons) towards Physiotherapy as reported by the patients. Secondarily, it was of interest to see how the treatment strategies by the Physiotherapist affect patient satisfaction. Methods: The study was conducted at the orthopedic pain center in the Physiotherapy department at a tertiary care hospital in Mumbai, India. Personal interviews were conducted with 193 patients using a valid questionnaire. Results: The average age of the subjects was 47.5 years. Average duration of pain was close to 8 years, with low back pain being the most common location of pain. Majority of the patients were not referred for any particular Physiotherapy treatment (37.32%). Almost an equal percentage of subjects (33.16%) were referred for both exercise and electrotherapy treatments to the Physiotherapy department. Most of the times (around 68%), there was agreement in the treatment modes suggested by the referring doctor and the attending physiotherapist. However, in about 32% of the patients referred, there seemed to be a mismatch. Conclusions: The referring doctors (physicians/surgeons) gave considerable freedom to the physiotherapists regarding the treatment of chronic musculoskeletal pain. Some of them seemed to recommend electrotherapy as a treatment mode, due to which, there was dissatisfaction amongst patients about the treatment methodologies recommended by the physiotherapist. Keywords: Referral, physiotherapy, chronic musculoskeletal pain, perspectives