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.