Physiotherapists’ and general practitioners’ views of self-referral and physiotherapy scope of practice: results from a national trial

AimTo establish the views of physiotherapists and general practitioners (GPs) on self-referral and physiotherapy scope of practice.DesignSurvey questionnaire design utilising both qualitative and quantitative questioning.SettingTwenty-six general practices throughout Scotland.ParticipantsSixty-four physiotherapists and 97 GPs with direct experience of implementing systems of self-referral to physiotherapy in primary care in Scotland.MethodQuestionnaires containing a mix of open and closed questions were distributed at the end of a year-long data collection period of a national trial (2003–2005). Responses were analysed by clinician group: GPs and physiotherapists.ResultsAn overall response rate of 73% (117/161) was achieved. High levels of comfort with, and confidence in, physiotherapists acting as first point of contact practitioners were reported by 96% (67/70) of GPs, and just 6% (3/47) of physiotherapists reported not being comfortable. More than 78% (91/117) of all clinicians indicated that there could be possible and definite benefits for musculoskeletal patients if physiotherapists were involved in monitoring and prescribing non-steroidal anti-inflammatory drugs, issuing sickness certificates and requesting X-rays, although this was more strongly supported by physiotherapists (>88% vs >63%; P < 0.001). Seventy-eight percent (35/47) of physiotherapist respondents felt that physiotherapists could accept self-referrals very ably, 47% (21/47) felt that not all physiotherapists were sufficiently experienced, and 16% (7/47) reported the need for additional training before physiotherapists could undertake this role. Only 34% (16/47) of physiotherapists felt that the public understood what physiotherapy is and what it can offer.ConclusionThe concept of physiotherapists working as first point of contact practitioners is strongly supported by the majority of GPs and physiotherapists. Potential benefits for patients were identified if physiotherapists undertook extended roles with regard to other aspects of musculoskeletal management. There is a need to address both professional and public awareness of physiotherapy and self-referral specifically.