Clinical Level Factors That Affect Quality of Physical Therapy Care of Patients With Low Back Pain: What's the Next Step?

Participants: Linda Resnik, PT, PhD, OCS, Niteesh K Choudhry, MD, and Lisa Zuber, PT, PhD. Moderator: Daniel Riddle, PT, PhD, FAPTA, PTJ Deputy Editor

Files in this Data Supplement:

• Discussion Podcast - In an article that Moderator Daniel Riddle describes as “certainly one of the more important and more controversial” articles in his 25 years of association with PTJ, Resnik and colleagues reported characteristics related to differences in practice outcomes and service utilization. Their findings suggested that, “in the treatment of patients with low back pain syndromes, clinics that are low utilizers of physical therapist assistants are more likely to provide superior care.” This discussion focuses on the use of physical therapist assistants in the provision of care and the impact of clinical experience on care quality. The participants also discuss the role clinical experience in the larger picture of health care quality and health care policy. Resnik states that “there are very strong pressures to deliver care as cheaply as possible” and that her study shows that “efforts to replace PT services with PTA services, which may be cheaper to deliver, could have negative impacts on quality of care.”

  “This type of information can cause patients to be better consumers.””

  “The caution … in interpreting this information is that it is not dose-responsive.”

  “I felt very strongly that really this might not be a measure of quality at all but a measure of dissatisfaction”

  Running time: 25:39 (12,036 KB)

  Reference

  Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med. 2005;142:26o-273.