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Mancino A1, Zaech Y1, Luder G1,2
1Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland, 2Bern University Hospital, Department of Physiotherapy, Bern, Switzerland
Background: In Switzerland, medical doctors, especially general practitioners (GP), mainly prescribe physiotherapy. This requires good knowledge about the role and competencies of physiotherapists (PT). Additionally, modern medicine may be more effective with successful inter-professional cooperation. To this end, adequate knowledge about other medical professions is increasingly important. Finally, to advance direct access to physiotherapy in Switzerland the support from other professions might be essential, mainly form the GP´s.
Purpose: This qualitative survey aimed to evaluate how GP perceive the role and competencies of PT's in Switzerland. Additionally, their position on direct access to physiotherapy was investigated.
Methods: Five GP's with different demographic and work-related backgrounds were interviewed for about 30 minutes using a semi-structured survey. Questions were based on previous surveys in the population and with politicians. Topics included the specialties of PT's, the confidence in physiotherapy treatment, the use of prescriptions and the opinion to direct access. All interviews were verbally transcribed using the software f5. Subsequently, they were analyzed with qualitative content analysis according to Mayring to identify main themes and categories and to describe possible relations.
Results: All five GP's showed adequate basic knowledge of physiotherapy. However, PT's were estimated to work mainly with musculoskeletal patients. The fields of internal medicine, geriatrics, paediatrics, or psychosomatics were rarely mentioned. All GP´s mentioned that physiotherapy was very important, though, they declared a lack of confidence in the competencies of the profession, mainly concerning diagnosis. All GP's reported to have more confidence in PT's with whom they had a personal relationship. All GP's regularly prescribed physiotherapy, which included about 5 to 10 referrals every week. Chief concerns regarding direct access to physiotherapy were an expected increase in health care costs and the lack of confidence in PT's capability to make a correct diagnosis.
Conclusion(s): GP´s primarily allocated physiotherapy to the musculoskeletal field, while other important domains like internal medicine, geriatrics, neurology or sports were rarely or not mentioned. All GP's frequently referred patients to PT's. However, the confidence that PT's manage the patient correct was low, except when the GP had a personal relationship to the PT. Thus, joint session in the basic or continued education and meetings at congresses might help to build mutual trust and confidence. Further, regular discussion of patients' progress to build trust and confidence in each other are recommended. Further research, also with larger surveys and in other medical specialties, should be undertaken to confirm these results.
Implications: Good knowledge of the competencies of other professions is an important foundation for the effective inter-professional cooperation. This qualitative survey additionally emphasized the importance of building professional relationships and mutual trust between GP´s and PT´s in Switzerland. Learning together during education and professional meetings might improve confidence and lead to a better understanding of each other's roles and competencies.
Keywords: Interdisciplinary Communication, direct access
Funding acknowledgements: No funding has been received for this study.
Purpose: This qualitative survey aimed to evaluate how GP perceive the role and competencies of PT's in Switzerland. Additionally, their position on direct access to physiotherapy was investigated.
Methods: Five GP's with different demographic and work-related backgrounds were interviewed for about 30 minutes using a semi-structured survey. Questions were based on previous surveys in the population and with politicians. Topics included the specialties of PT's, the confidence in physiotherapy treatment, the use of prescriptions and the opinion to direct access. All interviews were verbally transcribed using the software f5. Subsequently, they were analyzed with qualitative content analysis according to Mayring to identify main themes and categories and to describe possible relations.
Results: All five GP's showed adequate basic knowledge of physiotherapy. However, PT's were estimated to work mainly with musculoskeletal patients. The fields of internal medicine, geriatrics, paediatrics, or psychosomatics were rarely mentioned. All GP´s mentioned that physiotherapy was very important, though, they declared a lack of confidence in the competencies of the profession, mainly concerning diagnosis. All GP's reported to have more confidence in PT's with whom they had a personal relationship. All GP's regularly prescribed physiotherapy, which included about 5 to 10 referrals every week. Chief concerns regarding direct access to physiotherapy were an expected increase in health care costs and the lack of confidence in PT's capability to make a correct diagnosis.
Conclusion(s): GP´s primarily allocated physiotherapy to the musculoskeletal field, while other important domains like internal medicine, geriatrics, neurology or sports were rarely or not mentioned. All GP's frequently referred patients to PT's. However, the confidence that PT's manage the patient correct was low, except when the GP had a personal relationship to the PT. Thus, joint session in the basic or continued education and meetings at congresses might help to build mutual trust and confidence. Further, regular discussion of patients' progress to build trust and confidence in each other are recommended. Further research, also with larger surveys and in other medical specialties, should be undertaken to confirm these results.
Implications: Good knowledge of the competencies of other professions is an important foundation for the effective inter-professional cooperation. This qualitative survey additionally emphasized the importance of building professional relationships and mutual trust between GP´s and PT´s in Switzerland. Learning together during education and professional meetings might improve confidence and lead to a better understanding of each other's roles and competencies.
Keywords: Interdisciplinary Communication, direct access
Funding acknowledgements: No funding has been received for this study.
Topic: Professional issues; Globalisation: health systems, policies & strategies; Service delivery/emerging roles
Ethics approval required: No
Institution: Bern University of Applied Science
Ethics committee: Internal Board
Reason not required: According to Swiss legislation, no approval was necessary since no personal health-related data was collected.arget individual healt information of the involved persons
All authors, affiliations and abstracts have been published as submitted.
