First-contact physiotherapists' perceived competency in a new model of care for low back pain patients: a mixed methods study.
Amélie Kechichian, Elsa Viain, Thomas Lathière and 2 others
PMID 39285952WHAT IT FOUND
Nine French physiotherapists working as first-contact practitioners felt competent diagnosing acute low back pain and referring for physiotherapy, but less competent prescribing NSAIDs and issuing sick leave.
Experience, training, collaboration, and risk shaped confidence.
Key findings
01Nine physiotherapists were included for both quantitative and qualitative data collection.
02On the 4-point survey, participants felt very competent with medical diagnosis (3.44/4), analgesic prescription (3.11), and physiotherapy referral (3.78/4), but did not feel competent with NSAID prescription (2.78) or sick leave certificate issuance (2.67).
03Interviews identified four themes: experience, knowledge and training; collaboration with family physicians; higher responsibility and risk management; and formal training or model changes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only nine physiotherapists, so the findings may not represent all French physiotherapists or other countries. It measured self-perceived competency, not actual clinical performance or patient outcomes. The first-contact model was deployed in a limited number of primary healthcare centers, and participants had limited exposure to it. The French model differs from international advanced practice physiotherapy models.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Union Régionale des Professionnels de Santé Masseur-Kinésithérapeutes of the Auvergne-Rhône-Alpes region and the Conseil National de l'Ordre des Masseurs-Kinésithérapeutes as part of a doctoral project. The funders were not involved in design, data collection, analysis, interpretation, or writing.
The easy way to misread this
Do not read the high self-rated competency scores as evidence that the first-contact model is safe or effective. The study measured nine physiotherapists' perceptions, not patient outcomes or actual clinical performance.