Physical Therapist vs. Family Practitioner Knowledge of Simple Low Back Pain Management in the U.S. Air Force

Ross, Michael D.; Childs, John D.; Middel, Cory J.; Kujawa, Julie; Brown, Daniel R.; Corrigan, Molly; Parsons, Nate

doi:10.7205/milmed-d-13-00099

Cited by 13 publications

(16 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Once individuals completed the survey, they returned it to the primary investigator via a stamped envelope that was provided. Participants were asked if they had previously read the research performed by Buchbinder et al [5], Finestone et al [6], and Ross et al [7]. Those familiar were excluded from the data analysis, as the correct responses to each item were included in that research.…”

Section: Agree Strongly Agreementioning

confidence: 99%

“…One limitation from the Ross et al [7] study is that the results may not be generalizable to non-military physical therapy practice settings. Physical therapists in the uniformed services also have extensive additional orthopedic training in managing patients with neuromusculoskeletal conditions without physician referral.…”

Section: Introductionmentioning

confidence: 99%

“…More recently, Ross et al [7] compared knowledge in managing patients with LBP between physical therapists and family practice physicians. In total 54 physical therapists and 130 family practice physicians currently serving in the U.S. Air Force completed standardized examinations assessing knowledge, attitudes, the usefulness of clinical practice guidelines, and management strategies for patients with LBP [5,6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The knowledge of low back pain management between physical therapists and family practice physicians

Ross

Adams

Engle

et al. 2018

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

Objectives: The purpose of this study was to compare knowledge in managing patients with low back pain (LBP) between physical therapists and family practice physicians. Methods: Seventy-three physical therapists and 30 family practice physicians completed standardized examinations assessing knowledge, attitudes, the usefulness of clinical practice guidelines, and management strategies for patients with LBP. Beliefs of physical therapists and family practice physicians about LBP were compared using relative risks and independent t-tests. Results: Scores related to knowledge, attitudes, and the usefulness of clinical practice guidelines were generally similar between the groups. In addition, there was no difference between the groups for knowledge regarding optimal management strategies for patients with LBP. However, physical therapists were less likely to have difficulty assessing motivation levels of patients with LBP compared to family practice physicians (64.6% vs 26.7%; relative risk: 2.41 [95% confidence interval: 1.30-4.48] and physical therapists were less likely to agree that interventions by health care providers have little positive effect on the natural history of acute LBP (17.8% vs. 50.0%; relative risk: 0.36 [95% confidence interval: 0.19-0.66]). Discussion: The results of this study may have implications for third-party payers and health care administrators regarding the utilization of physical therapists in the management of patients with LBP in expanded scopes of practice, including direct access and potential placement in primary care clinics.

show abstract

Section: Agree Strongly Agreementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The knowledge of low back pain management between physical therapists and family practice physicians

Ross

Adams

Engle

et al. 2018

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

show abstract

“…CAPTE requires all USA PT students receive "content and learning experiences" assessed via "student testing and evaluation processes" in musculoskeletal imaging (Boissonnault, White, Carney, Malin, & Smith, 2014;CAPTE, 2017b). USA PTs have emerged as the leaders in conservative management of musculoskeletal conditions, as they have repeatedly been shown to have superior musculoskeletal knowledge when compared with nonorthopaedic physicians and other healthcare providers (Childs et al, 2005;Childs et al, 2007;Ross et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Physical therapy musculoskeletal imaging authority: A survey of the World Confederation for Physical Therapy Nations

Mabry

Boyles

Brismée

et al. 2019

Physiotherapy Res Intl

View full text Add to dashboard Cite

Objectives Medical evidence largely supports PTs in expanded roles, however, healthcare policy within the United States (USA) typically restricts PTs from ordering musculoskeletal (MSK) imaging. It is unknown how MSK imaging policy in the USA compares to other World Confederation for Physical Therapy (WCPT) member nations. The primary objective of our study was to investigate the authority of PTs to order MSK imaging. A secondary objective was to identify factors associated with the authority for PTs to order MSK imaging. Methods 111 WCPT member nations were surveyed over a 2‐month period on the authority of PTs ordering MSK imaging within their nation. A secondary analysis utilizing a step‐wise binary regression compared member nation demographic statistics to MSK imaging authority. Results 81 member nations responded to the survey. 31 (38.3%) of member nations reported having some level of PT MSK imaging authority while 50 (61.7%) did not. Member nations with lower per capita healthcare costs were significantly more likely to allow PTs to order MSK imaging (p = 0.02). Those with direct access authority were 7.4 times more likely to authorize PTs to order MSK imaging (p < 0.01). Entry‐level clinical degree and years of entry‐level collegiate credit were not associated with imaging authority. Conclusion This is the first study to report MSK imaging policy within the WCPT member nations. While many nations within the WCPT allow PTs to order MSK imaging, the majority of nations still restrict PTs from such practice. Lower per capita healthcare costs and direct access authority were significant predictors of MSK imaging authority, however, causation cannot be established within the confines of this study. Future studies should consider issues such as restrictive policy origin (i.e. governmental vs. institutional), insurance reimbursement (i.e. private vs. public sector policy), and limitations on imaging modality

show abstract

“…There is emerging evidence from other settings that suggests that PTs can adopt the primary care role with good clinical outcomes and improvements in healthcare efficiency. Studies in the United States military have shown that when PTs provide the first point of contact care for those with work-related injuries this produces high satisfaction ratings, faster access, decreased sick calls, and more appropriate use of PTs and physicians [ 24 , 34 – 38 ]. Evidence on the transition from physician referral to direct access physiotherapy in the United Kingdom National Health Service found higher levels of patient and physician satisfaction, shorter physician wait times, fewer work absences, fewer diagnostic images, and lower prescription medication use [ 39 – 41 ].…”

Section: Introductionmentioning

confidence: 99%

Determining the impact of a new physiotherapist-led primary care model for back pain: protocol for a pilot cluster randomized controlled trial

Miller

Barber

Donnelly

et al. 2017

Trials

View full text Add to dashboard Cite

BackgroundBack pain is a leading contributor to disability, healthcare costs, and lost work. Family physicians are the most common first point of contact in the healthcare system for people with back pain, but physiotherapists (PTs) may be able to support the primary care team through evidence-based primary care. A cluster randomized trial is needed to determine the clinical, health system, and societal impact of a primary care model that integrates physiotherapists at the first visit for people with back pain. Prior to conducting a future fully powered cluster randomized trial, we need to demonstrate feasibility of the methods. Therefore, the purpose of this pilot study will be to:Determine feasibility of patient recruitment, assessment procedures, and retention.Determine the feasibility of training and implementation of a new PT-led primary care model for low back pain (LBP)Explore the perspectives of patients and healthcare providers (HCPs) related to their experiences and attitudes towards the new service delivery model, barriers/facilitators to implementation, perceived satisfaction, perceived value, and impact on clinic processes and patient outcomes. MethodsThis pilot cluster randomized controlled trial will enroll four sites and randomize them to implement a new PT-led primary care model for back pain or a usual physician-led primary care model. All adults booking a primary care visit for back pain will be invited to participate. Feasibility outcomes will include: recruitment and retention rates, completeness of assessment data, PT training participation and confidence after training, and PT treatment fidelity. Secondary outcomes will include the clinical, health system, cost, and process outcomes planned for the future fully powered cluster trial. Results will be analyzed and reported descriptively and qualitatively. To explore perspectives of both HCPs and patients, we will conduct semi-structured qualitative interviews with patients and focus groups with HCPs from participants in the PT-led primary care sites.DiscussionIf this pilot demonstrates feasibility, a fully powered trial will provide evidence that has the potential to transform primary care for back pain. The full trial will inform future service design, whether these models should be more widely implemented, and training agendas.Trial registrationClinicalTrials.gov, NCT03320148. Submitted for registration on 17 September 2017.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2279-7) contains supplementary material, which is available to authorized users.

show abstract

Physical Therapist vs. Family Practitioner Knowledge of Simple Low Back Pain Management in the U.S. Air Force

Cited by 13 publications

References 28 publications

The knowledge of low back pain management between physical therapists and family practice physicians

The knowledge of low back pain management between physical therapists and family practice physicians

Physical therapy musculoskeletal imaging authority: A survey of the World Confederation for Physical Therapy Nations

Determining the impact of a new physiotherapist-led primary care model for back pain: protocol for a pilot cluster randomized controlled trial

Contact Info

Product

Resources

About