Determinants of physician confidence in the primary care management of musculoskeletal disorders

J Rheumatol. 1996 Feb;23(2):351-6.


Objective: To examine the determinants of confidence in managing musculoskeletal (MSK) disorders among primary care physicians.

Method: A self-administered questionnaire was mailed to a stratified (by urban/rural location) random sample of 798 Ontario primary care physicians who were members of the College of Family Physicians of Canada. Two mailings and a reminder postcard were used to increase response. As the main outcome measure, confidence was measured on a 10 point Likert-type scale.

Results: The overall response rate was 68.3%. Most respondents were practising in a full time group setting; their average age was 40.3 years. Respondents were significantly more confident in performing a comprehensive cardiovascular examination than a MSK examination. Highest levels of confidence were observed for using nonsteroidal antiinflammatory drugs and managing common MSK disorders. Lower scores were reported for doing a joint injection/aspiration. Rural physicians were more confident than urban physicians in doing a joint injection/aspiration and monitoring patients who were taking disease modifying agents. Previous continuing medical education (CME) was significantly (p < 0.01) related to all confidence outcomes using multiple regression analysis. For many outcomes, men reported higher confidence scores than women after adjustment for various demographic characteristics.

Conclusion: CME may be the most important and modifiable variable to improve physician management of MSK disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Attitude*
  • Education, Medical, Continuing
  • Humans
  • Injections, Intra-Articular
  • Musculoskeletal Diseases / therapy*
  • Physicians*
  • Primary Health Care*
  • Regression Analysis
  • Sex Characteristics
  • Suction
  • Surveys and Questionnaires


  • Anti-Inflammatory Agents, Non-Steroidal