A Study of Outcomes Following Collaborative Medical Doctor/Physical Therapist Primary Care Service for Musculoskeletal Problems

Abstract

Background and Purpose: Collaborative medical doctor/physical therapist primary care services are not described in the literature. The 2 purposes of this observational study were to describe a collaborative medical doctor/physical therapist primary care service, and to describe simple, one question, outcomes including patient acceptable symptom state (PASS), global rating of normal function (GRNF), and success of treatment (SOT) at intake, 1 to 7 days, and 45 to 60 days follow-up. Methods: Patients were seen for 1 to 2 visits and typically received exercise, hands on treatment, ie, manual therapy, and education. Medical doctor/physical therapist collaborative encounters and provider training are described. Outcome measures were recorded at the first visit, via phone once between 1 to 7 days and once between 45 to 60 days. Descriptive data was calculated at each time point. Findings: Examples of collaborative diagnosis and treatment opportunities are tabulated. A total of 31.9% of patients were PASS Yes at intake (n=402). At 1 to 7 days (n=157; 50.3%) and 45 to 60 days (n=93; 55.9%), the proportion of PASS Yes patients were higher. There was little difference in the GRNF scale at any follow-up. At 45 to 60 days, the SOT question indicated most patients (45.7%) reported “improved” and 29.3% of patients reported as “partly cured” or “cured.” Clinical Relevance: Collaborative opportunities for diagnosis and treatment in primary care are provided. A model using the PASS, GRNF, and SOT questions for judging the urgency which a service needs modification to meet patient needs is proposed. Conclusion: A collaborative medical doctor/physical therapist model is a viable option to improve primary care services. This descriptive data suggests some level of success, however, there is little relevant data for comparison

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