The introduction of a direct access physiotherapy model in Norway may have led to an immediate drop of 391 general practitioner consultations per 10,000 individuals, according to a recent study.

In the study, published in Family Medicine and Community Health, investigators evaluated the impact of a nationwide direct access physiotherapy model on musculoskeletal (MSK) care, finding a reduction in general practitioner (GP) consultations in Norway. This interrupted time series analysis used data from over 82,072 participants, assessing primary and secondary care consultations from 2014 to 2021.

In 2018, Norway introduced a direct access physiotherapy model, permitting patients with MSK conditions (eg, back pain, and knee osteoarthritis) to seek care directly from physiotherapists without a referral. The study linked MSK consultations to national health registries, focusing on primary care (GP and physiotherapy consultations) and secondary care (specialist visits and surgical procedures).

The investigators demonstrated a decrease of 391 GP consultations per 10,000 individuals (95% confidence interval [CI] = −564 to −216) after the model’s introduction, with no corresponding change in physiotherapy consultation rates. Subgroup analyses showed reductions in physiotherapy consultations among participants with lower educational attainment: 150 consultations per quarter in the lowest education group (95% CI = −203 to −97) and 70 in the intermediate group (95% CI = −115 to −27). Additionally, a reduction of 2 spinal surgical procedures per 10,000 individuals was noted in those aged 40 to 60 years (95% CI = −3 to −1).

The findings indicated an association between direct access to physiotherapy and reduced GP workload in managing MSK conditions, without increasing the burden on physiotherapy services. 

Full disclosures can be found in the published study.