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Physical therapists may be an alternative to seeing a doctor first

Aging population will increase the number of patients doctors have to see

A large percentage of the population throughout the world is getting older. In the United Kingdom, the current percentage of the population over the age of 65 is 17%. This has grown from 15% in 1985 and is predicted to rise to 23% by 2035. Similar changes are also occurring here in the U.S. As a result of this increase in the elderly population, there will also be an increase in the number of health conditions that are related to old age. In particular, arthritis and painful conditions that affect the back, shoulders, and knees (musculoskeletal conditions) are all expected to rise. As it stands, most of these patients with musculoskeletal conditions go to see their general practitioner for treatment or a referral to another doctor. But as the population continues to age, it will become difficult–if not impossible–for general practitioners to handle the amount of patients seeking treatment.

Why physical therapy may be part of the solution

For this reason, something needs to be done to ease the load of patients seen by general practitioners. One possible solution is to have patients see a physical therapist for any musculoskeletal conditions first, instead of their general practitioner. Physical therapists typically see patients with these conditions and are well-equipped to diagnose them, treat them and/or refer patients elsewhere. Although some research has been conducted on this topic, additional evidence is needed to support this type of approach to treatment. Therefore, a study was conducted to evaluate if having patients see a physical therapist first for musculoskeletal conditions was safe and effective and if patients were satisfied with the treatment they received.

Patients from two physical therapy practices are evaluated

Two experienced physical therapists were placed at two general medical practices–one in the inner city and one at a university–to provide care for patients. When patients called to make an appointment for issues related to a musculoskeletal condition, they were given the option of seeing the physical therapist as an alternative to the general practitioner. Patients who went with this option were given one or two 20-minute appointments with the physical therapist, which was meant to be as similar to an appointment with a general practitioner as possible. During these appointments, patients were screened for other conditions and offered advice on how to deal with their pain, mainly with exercise and lifestyle changes. If it was determined that a patient needed ongoing physical therapy care, he or she was referred to the full-time physical therapist at their second appointment. All patients were given a questionnaire and assessed for measures like pain and function at their first appointment, and then again one and six months later.

Physical therapy first is safe, effective and less expensive

Results from this study showed that seeing a physical therapist instead of a general practitioner for a musculoskeletal condition was safe, as no patients experienced any negative effects from the treatment. It was also effective, as the majority of patients were found to improve their condition at one and six months later. In addition, 70% of patients who saw a physical therapist first reported that they were completely satisfied with the treatment they received. Finally, the physical therapy-first approach was found to be significantly less expensive than seeing a general practitioner first. Together, these findings show that visiting physical therapists for musculoskeletal conditions is both safe and effective, and less expensive than general practitioners. Considering the fact that up to 30% of complaints a general practitioner sees are related to musculoskeletal conditions, this shows that physical therapy may very well serve as an alternative for patients. More research is needed to investigate this matter in greater detail and confirm these findings, but this study provides hope for both general practitioners and patients alike to address the aging population issue. Patients may, therefore, consider making an appointment with a physical therapist rather than their general practitioner the next time they experience a musculoskeletal condition.

-As reported in the June '16 issue of Physical Therapy
July 20, 2017