Physical therapists perspectives on physician prescriptions
Abstract
Introduction: Physicians often refer to physical therapist yet communication between professions is frequently limited to the initial prescription. Evaluating how therapists perceive physician prescriptions may identify opportunities for improved communication. Methods: Descriptive electronic RedCap survey. Subjects recruited through Facebook and Instagram flyers posted by author. Results: 52.0% of respondents (N=175) felt physician prescriptions contain too little information (28.6% the right amount, 19.4% too much.) 41.1% reported information on the prescription only rarely changing treatment (36.0% occasionally, 6.3% often, 3.4% very often.) 33.7% feel physician prescriptions are “mostly out of date” with the MSK/rehab evidence (25.1% “sometimes out of date.”) 36.0% reported their clinical findings often conflicting with the physicians diagnosis (15.4% “very often,” 44.6% occasionally, 4.0% rarely, 0% never) 4.0% “always follow” the specific treatment instructions listed on the prescription. 21.7% “rarely” follow, 34.3% sometimes, 7.4% never, and 16.6% “most of the time. 42.3% find specific treatment instructions to be detrimental (52.0% neutral, 5.7% helpful.) When asked to rate importance of including imaging findings on a 0-5 scale with 5 being “extremely important” 37.7% selected 4/5 and 24.0% 5/5. When asked the same regarding precauti ons/contraindications 63.3% selected 5/5. Conclusions: Disconnect may exist between how physical therapists and referring physicians view therapy prescriptions. Perceptions of what constitutes “evidence-based” practice may also differ between professions. Direct communication should occur between professions to establish expectations and optimize prescription structure. A potential initial step may be inclusion of imaging findings and precautions/contra-indications on prescriptions sent.
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