Integrating physiotherapists within primary health care teams: perspectives of family physicians and nurse practitioners

Abstract

The international literature suggests a number of benefits related to integrating physiotherapists into primary health care (PHC) teams. Considering the mandate of PHC teams in Canada, emphasizing healthy living and chronic disease management, a broad range of providers, inclusive of physiotherapists is required. However, physiotherapists are only sparsely integrated into these teams. This study explores the perspectives of "core" PHC team members, family physicians and nurse practitioners, regarding the integration of physiotherapists within Ontario (Canada) PHC teams. Twenty individual semi-structured in-depth interviews were conducted, transcribed verbatim, and then analyzed following an iterative process drawing from an interpretive phenomenological approach. Five key themes emerged which highlighted "how physiotherapists could and do contribute as team members within PHC teams particularly related to musculoskeletal health and chronic disease management". The perceived value of physiotherapists within Ontario, Canada PHC teams was a unanimous sentiment particularly in terms of musculoskeletal health, chronic disease management and maximizing health human resources efficiency to ensure the right care, is delivered by the right practitioner, at the right time.

Comparing geographical distribution of community‐based physiotherapists and family physicians across Saskatchewan

“…It also provides evidence to inform progressive, comprehensive, and accessible PHC, all fundamental to actualizing the Act and benefiting the health of Saskatchewan residents. These findings further support the idea of integrating publicly funded PTs with the other PHC service providers such as FPs and/or nurse practitioners to improve population health and chronic disease management, particularly in areas of high potential need (Dufour et al ).…”

Integrated Care: Provider referrer perceptions of occupational therapy services for homeless adults in an integrated primary care setting

“…There is limited research on the role of occupational therapy in integrated primary care settings serving homeless adults, including contributions to the interdisciplinary team within this setting [1][2][3]. Federally Qualified Health Centers (FQHC) as a form of integrated primary care are designed to provide comprehensive primary and integrated health care to individuals who are low income and/or experiencing homelessness [4].…”

“…Perceived barriers to practice in integrated primary care settings include a historic delivery model that emphasized solo practice and the tradition in occupational therapy of remediation rather than prevention, as well as lack of funding [2,8]. As the role of occupational therapy within integrated care settings develops, it is critical to study the efficacy of occupational therapy interventions with those with complex co-morbid conditions in such settings, and to understand how these interventions can contribute to best practices and allocation of scarce resources.…”

“…Limited research exists surrounding referral behavior and perception of occupational therapy in primary care settings. Some found that physician's referral behavior was influenced by complex patient presentation such as pain [16]; patient need relative to chronic disease management [2]; and active outreach on the part of the occupational therapist [2,7]. A study of nurses' perception of occupational therapy [OT] in inpatient mental health emphasized the need for education regarding role delineation to assist interdisciplinary understanding of the potential value of occupational therapy contribution to client recovery [17].…”

“…A study of nurses' perception of occupational therapy [OT] in inpatient mental health emphasized the need for education regarding role delineation to assist interdisciplinary understanding of the potential value of occupational therapy contribution to client recovery [17]. Other studies echoed themes relative to perceived added value and quality of life, and the need to prioritize referrals [2,18]. Increased referrals were identified in settings with a strong history of team behavior and inter-professional communication, as well as a better understanding regarding the role of occupational therapy.…”