The role of the sports and exercise medicine physician in the National Health Service: a questionnaire-based survey

Abstract

Objectives: To investigate the opinions of general practitioners, orthopaedic surgeons, rheumatologists, sport and exercise medicine (SEM) registrars and public health consultants on training, caseload, the most appropriate setting and the position of SEM within the National Health Service (NHS) in the UK. Method: A cross-sectional questionnaire-based survey investigated the opinions of the above professionals from three primary care trusts and associated hospitals in London and Birmingham. Results: With a 50% response rate (n = 226), 93% (208/ 224) of participants felt that there was a role for SEM in the NHS. 56% (124/223) agreed that this role should be in both primary and secondary care. 64% (136/212) of participants felt that their practice would benefit from the input of a SEM physician and 95% (191/202) would consider referring patients to SEM services. 74% (165/ 222) agreed that SEM should have a public health role, and 63% (140/222) believed that these responsibilities should be evenly balanced with the treatment of sports injuries. Despite the emphasis on public health work from SEM policy makers, none of the SEM registrars selected public health as an important training area. 31% (44/140) of participants felt that a lack of education in the medical profession regarding SEM represented the greatest hindrance to its development in the NHS. Conclusion: Several areas of agreement were demonstrated across the specialties, many of which matched the views of policy makers. This study involved participants from a range of cognate disciplines and was the first to investigate this issue since SEM was recognised as a specialty in 2005.Sport and Exercise Medicine (SEM) was granted specialty status in the UK in 2005.

General practitioners’ attitude to sport and exercise medicine services: a questionnaire-based survey

“…A sample size calculation was performed using the Dilman and Cochran formulae indicating ∼248 respondents were required to generate representative results using a CI of 95% and a 5% margin of error 18 19. Previous questionnaire surveys of GPs showed response rates between 32% and 50% 13 20. As GPs have multiple time pressures, we assumed a response rate of approximately 35% and sent the questionnaire to all 693 GPs.…”

“…Although 60% of GPs in previous surveys felt that SEM should be a recognised speciality within the NHS, 64% believed that the NHS could not sustain it,12 with ambivalence on the best setting 13. Lack of education on the role of SEM was identified as the biggest barrier to speciality 13.…”

“…Although 60% of GPs in previous surveys felt that SEM should be a recognised speciality within the NHS, 64% believed that the NHS could not sustain it,12 with ambivalence on the best setting 13. Lack of education on the role of SEM was identified as the biggest barrier to speciality 13. The faculty of SEM have produced guidance10 suggesting a balance between treating sport injuries and chronic illnesses with exercise,14–17 but did not specify how SEM services should be implemented in practice nor how they can become incorporated within existing clinical musculoskeletal or chronic disease pathways thus limiting clarity for commissioners and referrers.…”

Sport and exercise medicine in the UK: what juniors should know to get ahead

“…This intermediary service2 has been advocated to meet the needs of the significant proportion of patients who do not require operative management, but need more specialised conservative input than what is generally available within the primary care setting. Most SEM consultant physicians have a dedicated clinic within primary or secondary care mainly within the private sector but encouragingly increasingly within the NHS.…”

Crossroads or threshold? Sport and exercise medicine as a specialty in the UK

“…I have no doubt that, once a few such posts are established, the true value of SEM will quickly become apparent and many others will follow. Indeed, the paper by O’Halloran and colleagues in this issue of BJSM demonstrates that there is already recognition from other medical specialists of the potential role of SEM within the NHS 4 . (see page ) As this survey was conducted in 2007, when training programmes were only just being created, there is reason to suppose that there would be even greater awareness if this were repeated today.…”