Electrotherapy for lower back pain and repeated manual therapy for a “frozen shoulder” are among six physiotherapy treatments the profession now believes are a waste of time and money.
The Australian Physiotherapy Association is the seventh organisation — the first in allied health — to target areas under the Choosing Wisely initiative, where practitioners and not funders aim to make better use of resources.
After consulting members and the Australian College of Physiotherapy, the APA has recommended physiotherapists no longer: request imaging for non-specific low back pain where there are no indicators of a serious cause; request imaging of the cervical pain in trauma patients unless indicated by a validated decision; request imaging for acute ankle trauma unless indicated by rules; routinely use incentive spirometry after upper abdominal and cardiac surgery; use electrotherapy in cases of lower back pain; and provide manual therapy for patients with “frozen shoulder”.
APA president Phil Calvert said the body had a renewed focus on quality practice and hoped to initiate conversations between physiotherapists and patients.
“In the past, there have potentially been consumer expectations — attend a physio and expect to get X, Y or Z — that were inappropriate, so this is our opportunity to correct that,” Mr Calvert said.
Physicians, radiologists, immunologists, radiologists, GPs, pathologists and emergency medicine specialists have already made recommendations. Next month ophthalmologists, nurses, intensive care specialists, surgeons, hospital pharmacists, infectious disease specialists, endocrinologists, haematologists, palliative care specialists, dermatologists, obstetricians and gynaecologists will do the same.
Inappropriate imaging, scans and tests are a common theme in the Choosing Wisely initiative and come as the federal government seeks to refine the Medicare Benefits Schedule and remove bulk-billing incentives in pathology and diagnostic imaging.
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