Assessment of general practitioners’ interests in expediting wait lists for spine surgical consultation with use of allied health professionals—results of a pilot study

Patrick A. Thornley, Stephan Oreskovich, Darryl Yardley, Ahmed Al-Jishi, Leah Wall, Edward Kachur, Aleksa Cenic


Background: General practitioners’ (GPs) opinions of non-physician clinician (NPC)-led triaging programs to expedite surgical consultation wait lists for patients presenting with non-urgent lower back pain (LBP) are not well described. Therefore, we targeted GPs practicing in Hamilton, Ontario and assessed their current experiences with referral to a single, large-scale spine surgery service as well as their feelings towards the implementation of triaging programs to improve the provision of health care.
Methods: A 21-item cross-sectional web-based questionnaire was disseminated to 281 active GPs referring to a single high-volume academic spine surgery centre. Likert-style questions assessed respondents’ current non-urgent LBP referral practices and experiences, as well as their receptiveness to a NPC-led triaging program. Descriptive data, which comprised the entire data set, were reported as counts and percentages.
Results: Among the 57 respondents (20% response rate; 57/281), there was an overwhelming dissatisfaction with current wait times for spine surgery consultation (91%; 52/57) despite referral practices being conservative with respect to the clinical indices that warrant diagnostic imaging and subsequent consultation. Ultimately, GPs strongly supported NPC-led LBP triage programs, feeling most comfortable with initiatives that are spearheaded by advance-practice physiotherapists (96%; 50/52). Finally, most respondents were interested in learning how to integrate triaging techniques into their own practice (81%; 42/52) to further expedite LBP patient assessments.
Conclusions: GPs expressed a strong support for LBP triage programs run by NPCs. Future investigation is needed to assess the cost-effectiveness, feasibility, and patient satisfaction of such an initiative.