Primary Care Practitioners’ Understanding of Physiatric Practice: Effects on Intention to Refer

McKenna, Cristin; Farber, Neil J.; Eschbach, Kelly S; Collier, Virginia U.

doi:10.1016/j.apmr.2004.09.014

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…First, the primary care providers who treat individuals with disabilities may not be aware of the scope of services offered by a physiatrist and how the specialty may benefit their patients [8,9]. As a result, they may not refer all the patients who may benefit from physiatric expertise [10]. Second, individuals who are referred to a physiatrist may experience geographic obstacles to accessing care.…”

Section: Introductionmentioning

confidence: 99%

Clinical Telerehabilitation: Applications for Physiatrists

Gregory

Alexander

Satinsky

2011

PM&R

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Telemedicine offers an innovative approach to increase access to rehabilitation medicine services for patients who live in areas where physiatrists are scarce or absent. This article reviews the current status of telerehabilitation services delivered through real-time videoconferencing to provide support, assessment, and interventions to individuals with impairments or disabilities. A literature review demonstrates various uses of telerehabilitation by physical therapists, occupational therapists, speech and language pathologists, audiologists, recreational therapists, neuropsychologists, nurses, other physician specialists, and physiatrists. We also provide more in-depth examples of 2 current programs that involve physiatrists: One furnishes telerehabilitation services to adult stroke survivors, and the other addresses the special health care needs of children with developmental disabilities. We discuss the benefits of using telemedicine via real-time videoconferencing to care for individuals with disabilities, outline the challenges of successfully implementing a physiatric telerehabilitation program, and finish with a list of potential applications for physiatrists interested in incorporating telemedicine into their practice. Further investigation of the use of telehealth technologies to deliver physiatric services, care coordination, and education is needed. We recommend that our professional societies develop and publish guidelines to facilitate development and use of telerehabilitation technologies to increase access to physiatric services.

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Section: Introductionmentioning

confidence: 99%

Clinical Telerehabilitation: Applications for Physiatrists

Gregory

Alexander

Satinsky

2011

PM&R

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“…[ 8 13 14 ] Researchers in Christiana Care Health System suggested that primary care physicians should also be educated about the benefits of referring patients to physiatrists. [ 15 ] It seems that education of medical students during clinical rotations could cause proper referral patterns. Considering the need for physician awareness on rehabilitative interventions in decreasing disabilities and early patient refer to rehabilitation specialist, we designed a PMR course for medical students with multidisciplinary therapists' involvement for the first time in Iran.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of physical medicine and rehabilitation course for undergraduate medical students

Razavi

Azadvari

Hosseini

et al. 2021

Journal of Education and Health Promotion

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BACKGROUND: The objective was to evaluate an innovative physical medicine and rehabilitation (PMR) course for undergraduate students of Tehran University of Medical Sciences and their attitude and knowledge change following course participation. MATERIALS AND METHODS: Ninety-one medical students filled the knowledge, attitude, and satisfaction forms pre- and postintervention. Nineteen medical students, two faculty physiatrists, two residents, two physical therapists, and two occupational therapists participated in the focus groups. RESULTS: We found significant attitude improvements. They declared the usefulness of PMR course for undergraduate. Moreover, they agreed that physiatrists could be first choice for refer of musculoskeletal patients and they preferred PMR as future career after course experience. Also, they preferred to refer musculoskeletal patients including carpal tunnel syndrome, frozen shoulder, nonspecific low back pain after course participation. We found a good relationship between attitude and practice scores ( r = 0.543, P = 0.000); in fact, students' attitude would strongly predict their practice through a model involving age, satisfaction, and exam scores ( R 2 = 0.356, B = 0.35 [0.06], and P = 0.000). CONCLUSION: We found that internship training course might be an effective method of teaching PMR. Improving attitude toward the field of PMR and patient referral practice, career choice and disability perceptions of undergraduates is concluded in this study. Investigation of the advantages of such courses in larger studies with longer follow-up time-points is highly recommend.

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What is the evidence on interventions to manage referral from primary to specialist non-emergency care? A systematic review and logic model synthesis

Blank

Baxter

Woods

et al. 2015

Health Services and Delivery Research

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BackgroundDemand management describes any method used to monitor, direct or regulate patient referrals. Several strategies have been developed to manage the referral of patients to secondary care, with interventions targeting primary care, specialist services, or infrastructure.ObjectiveThis research aimed to conduct an inclusive systematic review and logic model synthesis in order to better understand factors impacting on the effectiveness of interventions targeting referral between primary and secondary medical health care.DesignThe approach combined systematic review with logic modelling synthesis techniques to develop an evidence-based framework of factors influencing the pathway between interventions and system-wide changes.SettingPrimary health care.Main outcome measuresReferral from primary to secondary care.Review methodsSystematic searches were undertaken to identify recent, relevant studies. Quality of individual studies was appraised, with consideration of overall strength of evidence. A narrative synthesis and logic model summary of the data was completed.ResultsFrom a database of 8327 unique papers, 290 were included in the review. The intervention studies were grouped into four categories of education interventions (n = 50); process change interventions (n = 49); system change interventions (n = 38); and patient-focused interventions (n = 3). Effectiveness was assessed variously in these papers; however, there was a gap regarding the mechanisms whereby these interventions lead to demand management impacts. The findings suggest that, although individual-level interventions may be popular, the stronger evidence relates only to peer-review and feedback interventions. Process change interventions appeared to be more effective when the change resulted in the specialist being provided with more or better quality information about the patient. System changes including the community provision of specialist services by general practitioners, outreach provision by specialists and the return of inappropriate referrals appeared to have evidence of effect. The pathway whereby interventions might lead to service-wide impact was complex, with multiple factors potentially acting as barriers or facilitators to the change process. Factors related, first, to the doctor (including knowledge, attitudes and beliefs, and previous experiences of a service), second, to the patient (including condition and social factors) and, third, to the influence of the doctor–patient relationship. We also identified a number of potentially influential factors at a local level, such as perceived waiting times and the availability of a specialist. These elements are key factors in the pathway between an intervention and intended demand management outcomes influencing both applicability and effectiveness.ConclusionsThe findings highlight the complexity of the referral process and multiple elements that will impact on intervention outcomes and applicability to a local area. Any interventions seeking to change referral practice need to address factors relating to the individual practitioner, the patient and also the situation in which the referral is taking place. These conclusions apply especially to referral management in a UK context where this whole range of factors/issues lies well within the remit of the NHS. This work highlights that intermediate outcomes are important in the referral pathway. It is recommended that researchers include measure of these intermediate outcomes in their evaluation of intervention effectiveness in order to determine where blocks to or facilitators of system-wide impact may be occurring.Study registrationThe study is registered as PROSPERO CRD42013004037.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Primary Care Practitioners’ Understanding of Physiatric Practice: Effects on Intention to Refer

Cited by 4 publications

References 7 publications

Clinical Telerehabilitation: Applications for Physiatrists

Clinical Telerehabilitation: Applications for Physiatrists

Evaluation of physical medicine and rehabilitation course for undergraduate medical students

What is the evidence on interventions to manage referral from primary to specialist non-emergency care? A systematic review and logic model synthesis

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