Referrals

On my current musculo prac, I had a 58 year old male patient who suffered right Webber C ankle # post ORIF about 12 months ago. He has now developed plantarfasciitis in his right foot and his current main problems involve reduced dorsiflexion, tight calf muscles and ongoing pain in his right ankle and sole when walking. The last physio treatment sessions basically involve soft tissue massage, calf muscles stretching exercises, tapping and advices regarding orthotics However, improvements have not been made and benefits from physiotherapy have seemed to be plateaued.

After discussing with my supervisor, we decided to refer him back to orthopaedics and podiatry as well. There is no problem referring this patient straight to podiatry, however, in order to refer him back to orthopaedics, we need to write a letter to his GP to get his GP to refer him back to orthopaedics, in other words, we can only refer him to orthopaedics via his GP. After discussing with the patient, he did not seem to understand why we can’t refer him straight to orthopaedics, so he does not have to make another appointment with his GP. I was not very familiar with the hospital referral system so I had my supervisor to further explain to him and the patient finally agreed. My supervisor then told me that the hospital referral system is sometimes quite unintelligent and inconvenient for us (physiotherapy) and there is not much we can do except just following the rules. On reflection, I not only need to know how to treat the patient but also how to refer patients to other professionals and be aware of the protocol with different methods of referrals before discussing with the patients and also in the future when working in public sectors.