A physiotherapist may refer patients to a physician for the purpose of consultation.i The Referring for Physician Consultation practice guideline details Physiotherapy Alberta’s expectations regarding these referrals.
View the Referring for Physician Consultation practice guideline as a PDF.
- The Medical Schedule of Benefits makes explicit that physiotherapy referrals are for consultations (minor/major) not diagnostic procedures.
The referral and consultation process supports quality patient care. Physiotherapists are expected to:
- Ensure that referrals for consultation are made in patient’s best interest and with patient’s consent. If patient does not consent, the decision and any related discussion, should be documented in patient’s record.
- Consider if referral is required, when the request is initiated by the patient.
- Make reasonable efforts to ensure referral is not a duplication of service. Ensure there is sound rationale for referral.
- Ensure choice of consultant physician is appropriate. This should include consideration of the patient care issue, identification and disclosure of any perceived or real conflict of interest and determining if this is acceptable to the patient.
- Consider accessibility and wait list issues, and advocate for patients appropriately. Before making referral, advise patient of any known referral fees or charges.
- Ensure they have the knowledge, skills and abilities to coordinate any required follow-up services if the patient does not have a family physician or if the consultant physician does not have ongoing responsibility for patient. This may include assisting the patient to secure appropriate medical follow up.
- Periodically review referral/consultation process to maximize patient benefit. Quality improvements should be based on review findings. The review can include:
- Considering network of physicians to whom referrals are made.
- Quality of referral information provided to physician.
- Communication methods to/from physician.
- Relevance and value of consultation reports.
Providing relevant information to the consultant physician is critical. Physiotherapists are expected to:
- Ensure referral is structured in an appropriate format. Consultation requests can be made in many forms including letter, fax, e-mail, or verbally, but all must ensure the protection of health information in accordance with privacy legislation. A verbal request should be followed-up in writing.
- Ensure consultation request includes:
- Referring physiotherapist name, contact information and PracID number.
- Patient name and contact information.
- Consultant physician name and contact information.
- Referral date.
- Purpose and nature of referral including explicit clinical question(s) or other issues to be addressed by consultant physician.
- Sufficient detail of known patient history and physiotherapy care provided to date.
- Expectations regarding consultation, follow-up or ongoing provision of care.
Consultationi results should be integrated into patient management. Physiotherapists are expected to:
- Consider physician’s written recommendation(s) and determine most appropriate patient management. This can include but is not limited to: coordinating other services for patient, continuing to provide physiotherapy services or discussing other therapeutic options with patient, family physician or consultant.
- Be responsible and accountable for timely patient follow-up.
- Ensure when ongoing physiotherapy service is deemed appropriate, that relevant information from consultation is integrated into the patient management plan. If information is not integrated, the consultation’s value is compromised which results in increased healthcare system costs.
- The consultative process requires the physician provide the referring practitioner with a written recommendation following the consultation. A verbal report may precede the written report.