Attitudes toward management of patients with subacromial pain in Swedish primary care

Objective. We aimed to describe the attitudes among GPs and physiotherapist s toward the diagnostic approach and management of patients with a common s houlder disorder. Method. A questionnaire was sent out to 188 GPs and 71 physiotherapists. Th e total response rate was 71.8%. The questions were based on a written case simulation with cues about history and symptoms. Results. The results showed a unanimous opinion of the diagnosis. Rotator c uff tendinitis was marked as the most probable. The two groups showed simil arities in the way that they would examine the patient. The GPs referred th e patients to the physiotherapists significantly more often than the other way around. The most probable choice of treatment made by the GPs was non-s teroidal anti-inflammatory drugs (NSAIDs) and by the physiotherapists, move ment exercises together with ergonomics. Most treatment alternatives had at least 20% of the responders marking a neutral attitude, and few treatments were disregarded. Conclusions. We conclude that in Swedish primary care GPs and physiotherapi sts have a uniform diagnostic approach towards patients with subacromial pa in, but their choice of treatment reftects an uncertainty about the effecti veness of conservative treatments. The questioned pathogenesis of the sugge sted diagnosis and lack of research regarding the efficacy of conservative treatments could explain this uncertainty.