Monday 20th April : 11'ish
There is an important question of emphasis inherant in the results of your
audit: Although a doctor may be taught to recognise clinical pictures that
warrant emergency on-call treatment it should always be on the basis of a
request for advice. Hence a doctor requests the professional opinion of
another clinician who will view the clinical picture in a unique way.
So therefore are not all requests for on-call valid? Just because a
physiotherapist says that there is nothing they can do does not make it an
invalid request. I may ask a mechanic for advice on my car and what makes
it valid is exactly my lack of knowledge.
Many doctors have frustrations about their lack of understanding in
referring to physiotherapists, and I would argue that the only real forms
of inappropriate referral are when the doctor attempts to prescribe a mode
of treatment, or requests 'physiotherapy' for the patient on the assumption
that physiotherapy is the description of the act of treating, i.e. for
physio read 'tipping and tapping'.
Education is the most crucial issues, but I think giving the doctor
objective criteria for referral would be a bad idea, unless they were loose
enough to allow the physio some freedom within the refrerral.
Dave Nicholls
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