Effectiveness of physical therapists serving as primary care musculoskeletal providers as compared to family practice providers in a deployed combat location: a retrospective medical chart review

Mil Med. 2013 Oct;178(10):1115-20. doi: 10.7205/MILMED-D-13-00066.

Abstract

Objectives: A medical records review to compare efficiency and effectiveness of a physical therapist (PT) functioning as a musculoskeletal primary care provider (PCP) compared to family practice (FP) physicians functioning as musculoskeletal PCP.

Hypothesis: (1) Use of medication/imaging studies will be significantly less with a PT as PCP compared to FP as PCP. (2) Return-to-duty (RTD) rate will show significant increases when patients with musculoskeletal conditions are seen by PT as compared to FP.

Methods: One PT practicing in a deployed combat location collected data on patients that presented directly to the PT clinic or FP clinic for care of musculoskeletal complaints. Treatment patterns of two Air Force physicians were accessed regarding patients with musculoskeletal conditions. Fifty-four patients were randomly selected for the PT group and 95 patients for FP group. AHLTA was searched for cases reported from June 2009 to January 2010. Data regarding age, gender, medication, imaging use, and return to duty (RTD) rate were collected.

Results: Of the study population, 126 (84%) were males, 23 (16%) were females (age range: 19-54, mean 29). RTD rate was 50% greater for PT. Rate of medication and imaging use for PT was 24% and 11%, whereas FP was 90% and 82%, respectively (p < 0.01).

Conclusion: Using PT as the musculoskeletal PCP was shown to be an effective and efficient practice model to assess and treat patients with musculoskeletal complaints.

MeSH terms

  • Adult
  • Family Practice*
  • Female
  • Humans
  • Male
  • Medical Audit
  • Middle Aged
  • Military Medicine / methods*
  • Military Personnel*
  • Musculoskeletal Diseases / diagnosis*
  • Musculoskeletal Diseases / drug therapy*
  • Physical Therapy Specialty*
  • Professional Role
  • Retrospective Studies
  • Return to Work
  • United States
  • Warfare
  • Young Adult