Cases – www.specialist.physio

Below are some case examples of the ways that specialist physiotherapists can help and the breadth of skills they offer:

Patient

Fatima is a 49 year old, mother of three, who has lived with widespread back and leg pain for over twenty years. She has tried a range of medications, spinal injections, physiotherapy, chiropractic and exercise treatments.

Fatima has attended a specialist physiotherapist for an expert opinion on further options for managing her condition. She receives an evidence informed diagnosis, a list of the factors contributing to her problem, a plan for management, a time frame for expected progress with her plan and a follow-up appointment in six weeks.

Patient and telehealth

Peter is a 67 year old man with a 4 years history of rectal pain. He has long history of irritable bowel syndrome. He is unable to sit for any period without a cushion, and he finds driving any distance increases his pain. He seen multiple medical practitioners and has tried a range of medications, physiotherapy, chiropractic and exercise treatments. Peter lives in a rural location so attending appointments in the metropolitan area can be difficult.

Peter has attended a specialist physiotherapist for an expert opinion on further options for managing his condition. He receives an evidence informed diagnosis, a list of the factors contributing to her problem, a plan for management, a time frame for expected progress with his plan. The specialist physiotherapist arranges a follow up appointment via Telehealth and involves the local physiotherapist. Peter can attend physiotherapy in his local area under the guidance of the specialist physiotherapist.

Rural Physiotherapist and Telehealth

Marta is a recently graduated physiotherapist who works in a rural clinic that caters for clients in her regional community with a range of musculoskeletal and other health conditions.

When Marta has a client that she feels is more complicated or beyond her level of experience, she will arrange a second opinion session with a specialist physiotherapist. Marta attends this session via telehealth with her client. An assessment is undertaken and they are given a treatment plan with agreed goals to work on for a 6 week period.

There will then often be a follow-up review with the specialist physiotherapist at around 6 weeks to track progress and make further recommendations as needed.

Marta finds this process assists greatly in her clinical learning, helps with her confidence and her clients are happy with the rapid access to expert opinion and care.

Musculoskeletal Physiotherapist and a Second Opinion

Ben is a Musculoskeletal Physiotherapist who works in a private clinic that has a special interest in spinal pain. When he has a client who is not responding to treatment as expected, he will arrange a second opinion session with a specialist musculoskeletal physiotherapist. Ben attends this session with his client and is able to directly observe the consultation. He is then able to work on the agreed management plan with his client and undertake further follow-up review with the specialist physiotherapist in 6-8 weeks if needed.

General Practitioner

Dr Mohammad is a GP in general practice. She usually refers her patients to local physiotherapists for assistance with managing a range of health conditions. However, she recognises that at times some of her patients with more complex conditions or with multiple health conditions will benefit from management with a specialist physiotherapist. These patients are receptive to this option, as they have had previous experience with health professionals due to their chronic or complex conditions and understand the benefits of specialist care.

Dr Mohammad finds this particularly helpful when specialist medical care is not urgent and expert opinion can be provided without excessive waiting times.

Orthopaedic Surgeon

Dr Foster is an orthopaedic surgeon. His specialist areas are hip and knee problems. He will have some clients that may benefit from surgery, but it is not urgent, and he is not clear whether all appropriate non-surgical management has been tried first. Dr Foster will refer to a specialist physiotherapist for an opinion on whether there are other treatment options available before proceeding to surgery.

Neurosurgeon

Dr Ng is a neurosurgeon and pain management specialist. Many of her clients have complex pain conditions. Dr Ng will refer some clients for specialist physiotherapy input to help her provide whole-person management of their pain problems rather than just treating the local symptoms. This is usually a multidisciplinary process, where a health care team including clinical psychologist and specialist physiotherapist will provide guidance on an ideal care plan in consultation with each individual client.

Insurer

Bart is an injury management advisor for a workers’ compensation insurance company. His role is to monitor workers’ progress following a work injury and ensure they are on the right track to recovery. When a worker is not recovering as expected, despite being provided appropriate treatment, Bart will request a specialist physiotherapy review. This review process involves a review of relevant medical information and history, a thorough clinical examination and provision of a plan that is developed in consultation with the worker. This plan includes what further treatment is needed, any other barriers to recovery identified and is communicated to all relevant stakeholders so the worker can be supported in their recovery.