McMaster University

McMaster University

Surgeon Attitudes Towards Non-Physician Screening of Low Back Pain

MacOrtho is pleased to share with you the most recent publication titled "Surgeon Attitudes Towards Non-Physician Screening of Low Back or Low Back-Related Leg Pain Patients Referred for Surgical Assessment: A Survey of Canadian Spine Surgeons" published in Spine.

Find the abstract below and click here to access the full-version of the article.

Busse JW, Riva JJ, Nash JV, Hsu S, Fisher CG, Wai EK, Brunarski D, Drew B, Quon JA, Walter SD, Bishop PB, Rampersaud R. Surgeon Attitudes Towards Non-Physician Screening of Low Back or Low Back-Related Leg Pain Patients Referred for Surgical Assessment: A Survey of Canadian Spine Surgeons. Spine. 2013 Jan 15. [Epub ahead of print]

Abstract

Study Design: Questionnaire survey.

Objective: To explore spine surgeons' attitudes towards the involvement of non-physician clinicians (NPCs) to screen low back or low back-related leg pain patients referred for surgical assessment.

Summary of Background Data: Although the utilization of physician assistants is common in several healthcare systems, the attitude of spine surgeons towards the independent assessment of patients by NPCs remains uncertain.

Methods: We administered a 28-item survey to all 101 surgeon members of the Canadian Spine Society that inquired about demographic variables, patient screening efficiency, typical wait times for both assessment and surgery, important components of low back-related complaints history and examination, indicators for assessment by a surgeon, and attitudes towards the use of NPCs to screen low back and leg patients referred for elective surgical assessment.

Results: 85 spine surgeons completed our survey, for a response rate of 84.1%. Most respondents (77.6%) were interested in working with a NPC to screen patients with low back-related complaints referred for elective surgical assessment. Perception of suboptimal wait-time for consultation and poor screening efficiency for surgical candidates were associated with greater surgeon interest in a NPC model of care. We achieved majority consensus regarding the core components for a low back-related complaints history and exam, and findings that would indicate a surgical assessment was appropriate. A majority of respondents (75.3%) agreed that they would be comfortable not assessing patients with low back-related complaints referred to their practice if indications for surgery were ruled out by a NPC.

Conclusion: The majority of Canadian spine surgeons were open to a NPC model of care to assess and triage non-urgent or emergent low back-related complaints. Clinical trials to establish the comparative effectiveness and acceptance of the NPC model of care by all stakeholders are urgently needed.

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