Impact of interprofessional embedding of physical therapy in a primary care training clinic

ABSTRACT

Musculoskeletal pain is a prominent complaint in primary care resulting in increased referrals to physical therapy (PT); however, the referral system often results in delays and discontinuation of care. Several models have been developed to improve the referral process including integrating PT into primary care clinics. The Veterans Health Administration (VHA) Center of Excellence in Primary Care Education (CoEPCE), which educates post-graduate trainees in interprofessional teams, began (in 2015) embedding physical therapists into primary care clinics enabling patients to see a physical therapist during their primary care visit. To evaluate the efficacy of this model we tracked the numbers of PT referrals, the number of completed referrals, and the length of time between referral and completion. PT referral parameters from PT-integrated trainees in the CoEPCE were compared to two traditional primary care training clinics at the same VHA site (Firm A and Firm B). Results indicate that the CoEPCE placed and completed more PT referrals and did so with a shorter turnaround time than was seen in the other two clinics. Further analysis suggests that the decreased turnaround time can be attributed to the integration of PTs into the primary care clinic. The results support extending the use of interprofessional clinics that integrate PT into primary care settings.

KEYWORDS:

• Physical therapy
• primary care
• interprofessional care
• collaboration
• practice

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This work was supported by the VA Office of Academic Affiliations [10A2D].

Notes on contributors

Sharen E. McKay

Sharen E. McKay has a PhD in Neuroscience and was the Associate Director for Evaluation in the Center of Excellence in Primary Care Education.

Frank D. Buono

Frank D. Buono has a PhD in Rehabilitation and is Associate Research Scientist in the Department of Psychiatry at Yale School of Medicine.

Jennifer Walker

Jennifer Walker is a Doctor of Physical Therapy working in the outpatient orthopedic setting at VACT and as physical therapy faculty in the Center of Excellence in Primary Care Education.

Carly Glinski

Carly Glinski is a Doctor of Physical Therapy working in the outpatient orthopedic setting at VACT and was part of the Center of Excellence in Primary Care Education.

Destiny M. B. Printz

Destiny M.B. Printz is a doctoral student in Clinical Psychology at the University of Connecticut and was the Psychology Technician for the Center of Excellence in Primary Care Education.

Rebecca Brienza

Rebecca Brienza is an Internal Medicine physician and Director of the VACT Center of Excellence in Primary Care Education and is an Associate Professor in the Department of Medicine, Yale School of Medicine.