What does your work involve?
I work as a clinical physiotherapist seeing patients with a wide variety of musculoskeletal conditions in a small town primary care centre.
I was one of the first physiotherapists to take on this role over 20 years ago. I soon found that seeing patients referred by their GP so early with their musculoskeletal problems improved their treatment outcome and it also helped with the education and future management of their problem.
At the time I came into the post it was very innovative for GPs to refer directly to a physiotherapist. Happily I can say that this new physiotherapy role has proved very successful and many GPs now have direct access to physiotherapy services.
Why did you choose to do this work?
I'm one of a growing number of physiotherapists who have pushed the boundaries of physiotherapy practice to meet the needs of the patients we see in primary care.
For me personally developing the role of a physiotherapist working in primary care has been both exciting and rewarding. I've led or been part of ‘new’ physiotherapy service developments for musculoskeletal patients to access physiotherapy in a more timely way and also new treatment approaches.
The improvement process is never ending and these initiatives are still ongoing.
What do you do in a typical working day?
My typical day starts by seeing patients with musculoskeletal problems referred to me by their GPs. I have time allowed for a full and detailed initial assessment and treatment session with follow up appointments if necessary.
I'm involved with the development of patient pathways in primary care to help with their care. To encourage closer working, regular physiotherapy-led ‘drop in’ sessions for GPs provide a shared learning environment.
My day may also include supervising junior staff and students. Within our profession this primary care role has now been recognised as an important part of our practice.
Throughout my day completing patient documentation is important and working ‘on site’ I can input directly onto the patient electronic record providing a complete history as part of a multidisciplinary team approach to the patient’s problem.
What is the best thing about this job?
For me this job is being able to really make a real difference for patients suffering with musculoskeletal problems by seeing and treating them earlier in their condition and helping them manage their problem. My patients' feedback is very positive and they value this service.
What is the worst thing?
I can see so many more opportunities for physiotherapy to help patients with a variety of musculoskeletal problems in primary care but there's often the problem of funding new services. In some cases services have actually been cut to help meet the financial needs of the NHS.
How has research informed the work you do?
One of the frustrations I had in the early days was that I was often asking questions of my practice, as this was a new way of working for a physiotherapist. The available research evidence was limited for primary care and I decided to embark on my own research in one main area of questioning, that of managing back pain.
As with most research I found some answers but still a lot of unanswered ones and also new ones!
My quest still continues today and I am now involved in high quality research for musculoskeletal conditions that can be easily transferable and embedded into primary care physiotherapy practice.
Carol Doyle is a musculoskeletal clinical liaison research physiotherapist at the Arthritis Research UK National Primary Care Centre at Keele University and a clinical physiotherapist working for Cheshire East Community Health based in a primary care centre in Sandbach.