Physiotherapist referral to medical specialists and verbal prescriptions: how to use them in our patients’fundamental interest
The last months have seen discussion of two topics of great interest to Quebec physiotherapists, i.e. physiotherapist referral to medical specialists and physicians’ verbal physiotherapy prescriptions.
Let’s briefly discuss these two topics.
Physiotherapist referral to medical specialists Physiotherapists can refer their patients to medical specialists in cases within their field of expertise. Medical specialists, for their part, can accept and directly treat patients referred to them by physiotherapists. This benefits patients and the healthcare system alike while improving case management efficiency by allowing medical specialists to directly assess patients without a general practitioner’s referral. A physiotherapist referring a patient to an orthopedist would be just such a situation. This situation is far from unique, and other examples exist in the Quebec healthcare system. Optometrists, psychologists, or audiologists can refer patients respectively to an ophthalmologist, a psychiatrist, or an otorhinolaryngologist, for example.
What happens when a physiotherapist wants to refer a patient to a radiologist for an imaging test or therapy?
Certain radiologists offer patients various means of investigation and treatment, such as imaging tests or ultrasound-guided and radiological infiltrations. Such procedures usually require a medical prescription. To avoid longer wait times for patients who are in need of these procedures, some physiotherapists prefer to refer these patients directly to a radiologist. A radiologist who accepts patients referred by a physiotherapist must assume certain responsibilities to comply with his ethical obligations. In particular, radiologists must establish a diagnosis and develop a treatment plan that includes prescribing tests, examinations, and drugs. In addition, the radiologist must provide medical followup or, if the patient has a family physician, consult with him or her on the required medical followup. The followup can also be done in collaboration with the physiotherapist. Given the stakes involved, it is important for the sake of the patient that family physicians, physiotherapists, and radiologists establish mutual channels of collaboration and communication from the outset.
Besides directly referring a patient to a medical specialist, a physiotherapist who has been given a family physician’s verbal prescription can also serve as intermediary between family physician and medical specialist. For example, a family physician who has already assessed the patient’s clinical condition and who is working in close collaboration with a physiotherapist could, upon request from the family physician, give a verbal prescription for a radiological examination.
The physiotherapist will then fill out a radiological examination request according to the verbal prescription made by the family physician, who will be identified on the request form. Upon receiving the prescription, a health care professional will be authorized to perform the requested examination, and a radiologist will interpret the results and will send his or her findings to the family physician and the physiotherapist. The family physician will then be in charge of the proper followup.
For more information, please read the following relevant documents:
- La référence du physiothérapeute à un médecin spécialiste, par l’OPPQ: https://oppq.qc.ca/wp-content/uploads/2015/10/La-reference-duphysiotherapeute-a-un-medecin-specialiste.pdf
- Orienter n’égale pas prescrire, par le Collège des médecins: http://www.cmq.org/nouvelle/fr/orienternegale-pas-prescrire.aspx
Important professionnal inspection changes
In the current issue of Physio-Québec, the Professional Inspection committee details its new professional inspection policy. To streamline the process, the professional inspection forms will be quick and easy to fill out, while maintaining the same level of thoroughness as the previous professional inspection forms. Moreover, the professional inspection forms will reflect members’ specific situations and take into account whether the member is a clinician or not. You can learn more by reading the professional inspection column.
Denis Pelletier, pht., M. Sc.