Physiotherapists have been putting their case in the British Medical Association’s journal and an interesting discussion has ensued. Professor Nadine Foster of Keele University and two co-authors published a Personal View article titled ‘We need to rethink front line care for back pain’ (BMJ2011; 342:d3260). Questioning whether GPs were the best gatekeepers, they noted that musculoskeletal health and back pain were the main interests of physios, chiropractors and osteopaths. ‘They drive much research and professional development in these disciplines,’ the authors said.
NHS physio Richard Bartley, of Denbighshire, replied to a doctor who claimed, in a response posted online, that those practitioners tended to work without an evidence base. ‘NHS physiotherapists are increasingly abandoning guru-taught treatment techniques in favour of evidence-based combined physical exercise and cognitive behavioural remedies,’ said Mr Bartley. ‘Many GPs across the UK currently have rapid access to triage services run by NHS physiotherapists,’ he noted. ‘These physiotherapists undergo specialist training, and many have direct access to advanced imaging if needed. It is a system that works well.’