757 - Physical Therapists' Perspectives On Physician Prescriptions

Objectives: Physicians often refer to physical therapist yet communication between professions is frequently limited to the initial prescription. This study seeks to evaluate how practicing physical therapists perceive prescriptions they receive from physicians. Examination of this area may identify opportunities for improved communication between professions.

Design: Descriptive electronic RedCap survey. Subjects recruited through Facebook, Instagram, and Reddit flyers posted by author.

Results: 52.0% of respondents (N=175) felt physician prescriptions contain too little information (28.6% the right amount, 19.4% too much.) 41.1% reported information on the prescription only rarely changing treatment (36.0% occasionally, 6.3% often, 3.4% very often.) 33.7% feel physician prescriptions are “mostly out of date” with the MSK/rehab evidence (25.1% “sometimes out of date.”) 36.0% reported their clinical findings often conflicting with the physicians diagnosis (15.4% “very often,” 44.6% occasionally, 4.0% rarely, 0% never) 4.0% “always follow” the specific treatment instructions listed on the prescription. 21.7% “rarely” follow, 34.3% sometimes, 7.4% never, and 16.6% “most of the time. 42.3% find specific treatment instructions to be detrimental (52.0% neutral, 5.7% helpful.) When asked to rate importance of including imaging findings on a 0-5 scale with 5 being “extremely important” 37.7% selected 4/5 and 24.0% 5/5. When asked the same regarding precautions/contraindications 63.3% selected 5/5.

Conclusions: Disconnect may exist between how physical therapists and referring physicians view therapy prescriptions. Perceptions of what constitutes “evidence-based” practice may also differ between professions. Direct communication should occur between professions to establish expectations and optimize prescription structure. A potential initial step may be inclusion of imaging findings and precautions/contra-indications on prescriptions sent.