Have you ever wondered what the difference between doctors and physiotherapists are?
Are you confused as to who you should see when you do get that pain or injury? “What’s the difference?” is often a hard question to answer, but in this post, I will help you understand the:
- Qualifications of each profession
- Scope of practice
- Who you should see first, and
- Questions that you should be asking your health professional
I have had my fair share of injuries before my physiotherapy degree. And so, I also have had experiences with multiple trips to the physiotherapist or doctor. Unfortunately, among the good experiences, I’ve also had terrible consultations with physiotherapists and doctors.
My two worst experiences include:
- Getting told by my doctor, I should quit my sport because it would lead to long term damage
- Feeling like I was getting milked like a cash cow by my physiotherapist who kept me coming in every week for ‘maintenance’ check-ups
Although these two experiences don’t highlight the bulk of medical and physiotherapy professionals, it is helpful to know what you should and shouldn’t expect when getting reviewed by each profession. In this post, I will highlight who may be more appropriate to see, and some useful questions to ask about your pain or injury.
Breaking down the professions
There are many different types of physiotherapists and doctors. Each of these specialities requires various forms of training and experience. These include:
- Cardiorespiratory (heart and lung)
- Neurological (brain)
- Geriatrics (older adults)
- Paediatrics (children)
- Musculoskeletal (the muscles, joints, bones)
And many, many, MANY others specialities.
For this blog post, the ones that we mainly want to focus on are:
- Private physiotherapists
- General practitioners
These two practitioners are the ones you will most likely see when you have any initial onset of pain or injury.
Physiotherapy degrees can vary from 2 – 4 years depending on where you go to for physiotherapy. Physiotherapists are required to complete placements in private practices, hospitals or other services during this time. In which they are required to shadow or follow a qualified physiotherapist.
Physiotherapists operate under AHPRA (Australian Health Professional and Regulation Agency) and PBA (Physiotherapy Board of Australia). An additional affiliation that a majority of Australian physiotherapists have is the APA (Australian Physiotherapy Association).
In Australia, physiotherapists are classified as first contact practitioners and can see patients without a referral from a doctor. The physiotherapy system is different from many other countries which do require a doctor’s before the first consultation.
Some patients will still choose to see their GP’s first to get healthcare subsidies for their physiotherapy appoints.
University degrees for doctors can take 4 – 6 years, depending on where you go to for university. Upon graduation, doctors usually undertake a residency/internship, which is a rotation as a doctor in a hospital for a minimum of 1 year. After which, they must take further vocational training in the form of:
- FRACGP (Fellowship of Royal Australian College of General Practitioners) takes three years, or
- FARCRRM (Fellowship of Australian College of Rural and Remote Medicine) takes four years
Doctors operate under AHPRA (Australian Health Professional and Regulation Agency) and MBA (Medical Board of Australia). An additional affiliation that a majority of Australian physiotherapists have is the APA (Australian Medical Association).
Scope of Practice
Scope of practice essentially defines the actions and limitations of a healthcare provider, which can vary depending on any additional training that they may have undertaken.
In a general practice, a doctor can:
- Refer for MRI, X-ray or any other scans
- Prescribe medication (pain medication especially)
- Refer to a specialist for further review
- Refer to allied health professionals, such as physiotherapist, podiatrist or exercise physiologist.
The roles and duties of physiotherapists are:
- To perform a comprehensive subjective (verbal) and objective (hands-on) assessment
- Provide treatment and rehabilitation plan in the form of:
- Manual therapy or other hands-on modalities
- Exercise prescription and rehabilitation program
- Education of pain and injury
- Understanding when to refer on to a doctor or other healthcare practitioner
If you receive a referral from a Dr, you may be eligible for a Chronic Disease Management (CDM) plan. Under this management plan, a doctor must diagnose you with a “Chronic Medical Condition”, that is a condition “…present for six months or longer” before you are eligible for Medicare rebates for Allied Health Professionals.
Details of the rebates as follows:
- Five total visits in a calendar year (Note: unused visits in previous years do not roll over into the new year. A new referral must be made at the start of every new year).
- Currently, Medicare will only cover $54.60. If the physiotherapy practice charges more for their CDM clients, you may have to pay an out-of-pocket gap fee to cover the costs.
- Must be referred from the Doctor to the eligible physiotherapist using a referral form
(See The Department Of Health for more information).
So who should you see?
If you have acute pain or injury, then the first point of contact should be any healthcare practitioner that is available to your earliest needs. It doesn’t make sense if you have to wait two weeks for a physiotherapy consultation if the closest physiotherapist is booked out. Similarly, if your doctor is in a hectic period and is unable to meet with you, then the option to see a physiotherapist is also present.
For acute injuries, the recommendation would be to go to a physiotherapist. These generally settle within a few weeks, but having a physiotherapist to guide you and educate you on the path makes the journey much smoother.
If your pain or injury has been chronic and ongoing for an extended period, then referrals and communication should be made between both a physiotherapist and a general practitioner. This way, the two professions can create a treatment plan together that will best address the patient’s needs and help them improve.
Useful Questions to Ask Your Physiotherapist or Doctor
Below is a short infographic on the types of questions you should be asking your healthcare practitioner on your first consultation.
The world of healthcare practitioners is a complicated and hazy area. There are many crossovers between the roles and responsibilities of each profession.
Physiotherapists are your main contact for:
- Thorough assessment and identification of pain areas
- Treatment techniques to reduce pain and improve function
- Exercise rehabilitation for long term outcomes and recovery
General practitioners assume the responsibility of:
- Eliminating any major red flags; which include sending for investigations or referrals to specialist
- Prescribing pain medication
- Referral to allied health practitioners (including physiotherapists, podiatrists, dietitians or exercise physiologists)
So in the incident where you may have suffered an injury or have experienced some pain, go to whichever healthcare specialist is available in your area. In a future post, I will elaborate on what to look for in your healthcare worker and how to know whether you should be moving on!
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