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GPs go forth

It's enough to drive me to fist contact physiotherapy


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Rumour has it that our local musculoskeletal service may become open-access. Which seems to be on-trend, because among the subsidised new contract cavalry riding to our rescue are ‘first contact physiotherapists’, which I presume implies patient self-referral.

This sounds great: all those sprains, strains, aches and pains can amuse themselves with our physio rather than mentally spraining, straining, aching and paining us GPs.

So why does the one-access idea give me the heebie-jeebies?

For one thing, any deconstruction and hiving-off of our role is just another nail in the coffin of our ‘generalist’ USP. You could, of course, argue that being a less-stressed zombie GP is better than being an overwhelmed living one. But frankly, I prefer to be professionally alive, even if I do feel half-dead by close of play Monday.

And for another, the success or otherwise of ‘open-access’ is very much dependent on the approach of whatever it is the public is accessing. If first contact physios tell patients with a day or so of back pain, neckache, a sore thumb and so on that they should man up, use common sense and employ some time and NSAID gel, then fine. But if they see all-comers, dispense doses of pseudo-science, can’t live with diagnostic uncertainty and have direct access to investigation, then we are in danger of over-medicalising and ramping up patient expectation.

My worry is that they may lean to the latter approach, because they live in a world where they sometimes feel the need to justify their role by aggrandising the symptoms they see. Rather like pharmacists, in fact - another group coming to our rescue, but one living on a planet where trivia is monetised. And maximising minor self-limiting illness is the very opposite of our approach.

So, ‘First contact physiotherapist’? Nah. ‘Fist contact physiotherapist’, maybe.

Dr Tony Copperfield is a GP in Essex

Readers' comments (5)

  • But you have to admit Tony, there is some hilarity. Those guys who rode into the 'Valley of Dxxxx' had a 'blast'???

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  • They won’t have any obligation to meet demand though and once their appointments have filled guess where the overspill will go?

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  • Mark Heneghan- exactly......

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  • we have this but they now have three weeks waiting list so patients prefer to come to us initially as we can see them much quicker.

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  • We used to have self referral physio and it was so overwhelmed the waiting times went to close to a year and it was stopped.

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