Improving the referral process for orthopedic services: Results of the rehabilitation medicine access program (orthopedics)

LAY SUMMARY Many non-acute muscle and skeletal injuries can be rehabilitated with conservative management, such as physiotherapy or physiatry, rather than orthopedic surgery. In the primary care centre, the authors noted that almost half of patients with non-acute muscle and skeletal injuries referred to orthopedic surgery did not need orthopedic intervention. Referrals to orthopedic surgery, for which conservative management is more appropriate, contribute to wait times and delay the recovery process. To improve access to conservative management and reduce the demand for orthopedic services, this study looked at the benefits of using physiotherapists to screen electronic medical records (EMRs) to determine if patients needed orthopedic intervention or conservative management. The results show physiotherapy screening increased the percentage of patients referred to orthopedic surgery that truly required orthopedic intervention from 47.9% to 63.7%. This emerging practice may lead to shorter wait times for patients to see an orthopedic surgeon, fewer in-person assessments, and improved access to conservative treatment.