PATIENT PROFILE, REFERRAL SOURCES, AND CONSULTANT UTILIZATION IN A PRIMARY-CARE SPORTS MEDICINE CLINIC

BACKGROUND. Sports medicine has matured as a focused discipline within primary care with the number of primary care sports medicine physicia ns growing annually. The practices of these physicians range from ''pa rt-time'' sports medicine as a part of a broader practice in their pri mary specialty, to functioning as a full-time team physician for a uni versity or college. Managed care organizations are increasingly incorp orating primary care sports medicine providers into their organization s. The optimal role of these providers in a managed care system has no t been described. METHODS. A descriptive analysis was made of patient contacts in a referral-based, free-standing primary care sports medici ne clinic associated with a large managed care system. This study desc ribes patient information including demographic data, referral source, primary diagnosis, specialized diagnostic testing, and subsequent spe cialty consultation. RESULTS. A total of 1857 patient contacts were an alyzed. New patients were referred from a full range of physicians bot h primary care (family practice, internal medicine, pediatrics, and em ergency physicians) and other specialists, with family practice clinic providers (physicians, physician assistants, and nurse practitioners) accounting for the largest percentage of new referrals. The majority of patient visits were for orthopedic injuries (95.4%); the most frequ ently involved injury sites were: knee (26.5%), shoulder (18.2%), back (14.3%), and ankle (10%). The most common types of injury were: tendi nitis (21.3%), chronic anterior knee pain (10.6%), and ligament sprain s (9.9%). Specialized testing was requested for 8% of all patients. Th e majority of patients were treated at the Ft Belvoir Sports Medicine Clinic by primary care sports medicine physicians without further spec ialty referral, CONCLUSIONS. Primary care sports medicine physicians o ffer an intermediate level of care for patients while maintaining a pr actice in their primary care specialty. This dual practice is ideal in the managed care setting. This study demonstrates the complementary n ature of primary care sports medicine and orthopedics, with the primar y care sports medicine physician reducing the demand on orthopedists f or nonsurgical treatment, This study also demonstrates the need for re vision in the orthopedic curriculum for primary care physicians.