A new report from Nous Group revealed that allowing physiotherapists to make direct referrals could save the Australian healthcare system and patients an astounding $162.7 million annually. This new evidence supports the Australian Physiotherapy Association (APA) in their work advocating for a transformative policy change that would significantly improve the patient referral process.

The proposed changes include:

• Medicare Benefits Scheme (MBS) rebates for direct physiotherapist referrals to orthopaedic surgeons for musculoskeletal injuries and conditions.
• MBS rebates for additional diagnostic imaging items.
• Full participation of physiotherapists in My Health Record to ensure visibility of referrals to the patient’s healthcare team.

The report from Nous Group, commissioned by the APA, shows that the proposed policy change would lead to significant savings, with $98.6 million in savings for orthopaedic specialist referrals and $64.1 million for medical imaging services.

APA National President Scott Willis said this policy change would ease the process for many by allowing physiotherapists to work to the top of their scope.

‘This policy change promises to streamline the patient journey, eliminating unnecessary GP visits, cutting down wait times for diagnoses and treatments, reducing out-of-pocket expenses for patients, and providing savings for the health system as a whole,’ Mr Willis said.

Health Minister Mark Butler has repeatedly advocated for physiotherapists to work to the top of their scope, while Professor Mark Cormack has made it a priority for the "Unleashing the Potential of our Health Workforce – Scope of Practice Review" that referrals will be a key focus for the ground-breaking Scope of Practice Review. This supports the APA’s continuous efforts to improve access to essential care swiftly and cost-effectively.

‘Many patients need to either see a GP or present to an emergency department to request imaging to confirm a physiotherapist’s diagnosis. The APA calls for the immediate removal of costly structural barriers, which make it harder for patients to access the care they need when they need it, and for the implementation of new MBS-subsidised referral pathways to allow physiotherapists to directly refer to orthopaedic surgeons and request imaging for musculoskeletal conditions. This is fiscally responsible and puts the patient at the centre of care,’ Mr Willis said.

The Nous report also found that physiotherapists often refer patients to GPs simply to enable the patient to access MBS rebates.
‘Management of musculoskeletal injuries can be heavily reliant on the results of diagnostic imaging. There is an urgent need to expand medical imaging rights for physiotherapists for musculoskeletal conditions to enable physiotherapists to efficiently request imaging of the shoulder, elbow, wrist, hip, knee and ankle injuries for both adults and children.’ 

The report also found that advanced musculoskeletal physiotherapists are less likely to order imaging as they are highly skilled health professionals with a high accuracy in clinical assessment. 

Physiotherapists are well-equipped to diagnose and manage musculoskeletal conditions, determining responsibly where imaging referrals are required and ensuring appropriate referrals for further diagnostic imaging or specialist care.

Read the full report via the APA website.

References:
•    Nous Group. (2024). Direct Patient Pathways for Physiotherapy.
•    Marks, D., Comans, T., Bisset, L., & Scuffham, P. A. (2017). Substitution of doctors with physiotherapists in the management of common musculoskeletal disorders: A systematic review. Physiotherapy, 103(4), 341-351.
•    Australian Physiotherapy Association (2024) APA Federal Pre-Budget Submission 2024–25. Available at: https://australian.physio/sites/default/files/submission-2024-01/APA_Federal_Pre-Budget_Submission_2024-25_FINAL.pdf