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One-Time Physical Therapist Consultation in Primary Health Care

EJM Hendriks, PT, PhD, is a physical therapist in private practice, the Klepperheide, Druten, the Netherlands. He is also Senior Researcher and Manager, Program for Development and Implementation of National Clinical Practice Guidelines for the Allied Health Professions, Department of Research and Development, Dutch National Institute of Allied Health Professions (NPi), and Senior Researcher (Health Scientist and Clinical Epidemiologist), Department of Epidemiology and Centre of Evidence-Based Physiotherapy, Maastricht University, Maastricht, the Netherlands.
JJ Kerssens, PhD, is Psychologist and Senior Researcher, Netherlands Institute of Health Services Research (Nivel), Utrecht, the Netherlands
J Dekker, PhD, is Clinical Psychologist and Professor in Allied Health Care, Department of Rehabilitation Medicine, Free University (VU) Medical Centre, Amsterdam, the Netherlands
RM Nelson, PT, PhD, FAPTA, is Physical Therapist, Professor of Physical Therapy, and Chair, Department of Physical Therapy, Lebanon Valley College, Annville, Pa
RAB Oostendorp, PT, MT, PhD, is Physical Therapist, Manual Therapist, and Professor in Allied Health Care Research, Nijmegen University Medical Centre, Centre of Quality of Care Research, Nijmegen, the Netherlands. He is also Director, Dutch National Institute of Allied Health Professions (NPi)
J van der Zee, PhD, is Medical Sociologist and Professor in Primary Health Care Research, Department of Medical Sociology, Maastricht University, and Director, Netherlands Institute of Health Services Research (Nivel). Dr Hendriks, Dr Dekker, and Dr van der Zee provided concept/idea/ research design

Address all correspondence to Dr Hendriks at Department of Research and Development, Dutch National Institute of Allied Health Professions (NPi), PO Box 1161, 3800 BD Amersfoort, the Netherlands (hendriks{at}paramedisch.org)

Background and Purpose. One-time physical therapist consultation, prior to possible referral for physical therapy intervention, may enhance the quality of patient care, particularly if the referring physician is uncertain as to whether intervention by a physical therapist will be beneficial. The purpose of this study was to describe the use of consultation by a group of primary care physicians (PCPs) who could refer patients for a one-time consultation. Subjects and Methods. A 7-month observational study was conducted in the Netherlands with 59 pairs of randomly selected PCPs and physical therapists practicing in primary health care. Data were collected for the PCPs, the physical therapists, and the patients. Self-administered questionnaires (completed at the start and at the completion of the study), consultation request and report forms, and treatment referral records from health insurance agencies were used to obtain data. National reference data on patients referred by PCPs for intervention by a physical therapist were used to compare the data of patients referred by PCPs for a one-time consultation. The number and nature of consultation requests were determined as well as patient characteristics. The PCPs' satisfaction with the outcome and process of a one-time consultation and its impact on PCPs' management decisions also were described. Results. The number of referrals for a one-time consultation was 352 (=5.9 per PCP, SD=5.4, range=0–20), resulting in a mean referral rate of 4.7 per 1,000 patients (SD=4.6). Characteristics of patients referred for a one-time consultation differed from national reference data of patients referred by their PCP for intervention by a physical therapist. Discussion and Conclusion. The results show that PCPs used the opportunity for a one-time physical therapist consultation and were satisfied with the outcome and process of consultation. The findings suggest that a one-time consultation is an appropriate and beneficial component of PCPs' patient management process.

Key Words: Communication • Cooperation • Physical therapist consultation • Primary health care

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