In Australia, physiotherapists are only allowed to refer for X-rays but we
are currently lobbying for expansion of this (we have a federal election
coming up in October) to include MRI's, CATs and US. MRIs are still very
expensive here so is unlikely to be ordered too often. Any worker's
compensation client must have a doctor's authority for anything.
We would also need to have acceptance from private health funds so that the
clients can get a rebate.
Most back pain clients are referred directly by the GP (some refer
themselves directly) and are only sent to the Orthopod when there are
complications or the recovery is excessively slow. A good general
practitioner working in closely with a good physio, can resolve the problems
much faster and therefore may prevent progression into chronicity.
The NSW workers compensation legislation has just changed, based on an
extensive assessment and report into the system - it had been haemorrhaging
to death. As a consequence, GPs are now injury managers and the insurance
companies have also adopted the role of injury management instead of just
clims management. Should show some improvement. With this change is
comprehensive training for GPs.
There is also a big move towards, active rehab ie work conditioning. The
work conditioning industry have just completed a set of standards -
voluntary code at the moment. Many studies support this approach.
Regards, Anna
-----Original Message-----
From: [log in to unmask] <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Thursday, 10 September 1998 7:30
Subject: Referral for MRI scanning for back problems
>I'm involved in an area review of our NHS Orthopaedic services and the
>chairman of the group (a general practitioner) asked me if Physiotherapists
>were allowed to refer for a MRI scan for back problems? If so what would be
>the protocols?
>We are looking at establishing an area wide back pain triage system (large
>geographical area) with direct referral from general practitioners to
>specialist back pain physiotherapists to reduce the demands put on
orthopaedic
>consultants. Any comments?
>
>M Hastings
>
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