A primary care team approach to secondary prevention of work-related musculoskeletal disorders: Physical therapy perspectives

Article type: Research Article

Authors: Dropkin, Jonathan^{a; *} | Roy, Asha^b | Szeinuk, Jaime^c | Moline, Jacqueline^d | Baker, Robert^e

Affiliations: [a] Occupational Ergonomics, Workforce Safety, Northwell Health, Occupational Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA | [b] Workforce Safety, Northwell Health, Lake Success, NY, USA | [c] Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA | [d] Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, USA | [e] Rehabilitation Services, Outpatient Physical Therapy, Center for Orthopedics, North Bay Healthcare, Fairfield, CA, USA

Correspondence: [*] Address for correspondence: Jonathan Dropkin, ScD, PT, CPE Director, Occupational Ergonomics, Workforce Safety, Northwell Health, Associate Professor, Occupational Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 175 Community Drive, Suite 206, Great Neck, NY 11021, USA. Tel.: +1 516.330.3714; Fax: +1 516.465.2699;E-mail: jdropkin@northwell.edu.

Abstract: BACKGROUND: Among work-related conditions in the United States, musculoskeletal disorders (MSDs) account for about thirty-four percent of work absences. Primary care physicians (PCPs) play an essential role in the management of work-related MSDs. For conditions diagnosed as work-related, up to seventeen percent of cases are PCP managed; within these conditions, up to fifty-nine percent are diagnosed as musculoskeletal. Negative factors in treatment success confronting PCPs include time constraints and unfamiliarity with work-related MSDs. A multidimensional team approach to secondary prevention, where PCPs can leverage the expertise of allied health professionals, might provide a useful alternative to current PCP practices for the treatment of work-related MSDs. OBJECTIVE: Provide the structure of and rationale for an “extended care team” within primary care for the management of work-related MSDs. METHODS: A systematic literature search, combining medical subject headings and keywords, were used to examine eight peer-reviewed literature databases. Gray literature, such as government documents, were also used. RESULTS: An extended care team would likely consist of at least nine stakeholders within primary care. Among these stakeholders, advanced practice orthopedic physical therapists can offer particularly focused guidance to PCPs on the evaluation and treatment of work-related MSDs. CONCLUSIONS: A multidimensional approach has the potential to accelerate access and improve quality of work-related outcomes, while maintaining patient safety.

Keywords: Multidimensional, extended care teams

DOI: 10.3233/WOR-205139

Journal: Work, vol. 70, no. 4, pp. 1195-1217, 2021