As far as X-ray's are concerned can anyone please clarify exactly where we as physio's stand? I have received conflicting answers from a variety of sources. Some people saying that we can order them, but then they aren't covered by medicare, and others saying that it's better coming from a physio and if we believe it's warrented it should be done? I think the former sounds more familiar.
Recently I have come across three situations in which I believed an X-ray necessary. One patient had a fall and the next day started to complain of hip pain (worse than he had the previous day); secondly a lady presented to the outpatients department with a severe 'ankle sprain' which was very bruised and with some tingling in the toes a few days on; thirdly a lady with CVA and consequent global aphasia with very internally rotated hip, no increase in adductor tone and obvious pain (facial expressions) on hip and knee flexion - she however pointed to her knee as the source of the pain. The third case in particular was rather worrying and both my supervisor and I thought that an Xray to exclude dislocation of the hip, or infact a knee problem, was warrented. The nurses said I could order the Xray but agreed to inform the Doctor for me anyway, and the next day and X-ray was ordered and performed.
We are in a unique position to screen for if not diagnose fractures and dislocations, due to the fact our science is largely movement based. So once again I pose the question? Can we order X-rays? Secondly is it better for the patients hip pocket if we don't?
2 comments:
We are primary healthcare practitioners and can refer for xrays, however in the hospital environment I think the best approach is to liaise with the doctors although we would be perfectly within our rights to ask for an xray. Think team approach and keep everyone in the loop about your concerns for the patient.
If you are working in an out patient set up, for the cost sake, just refer your patient to their GPs. GP is our "gate keeper"-if we have any problem/issue that is beyond our training-just hand ball it to GPs. Foundamentally, we dont know much about medical imaging...However, I know some private radiology centres agree to give medicare discount to clients refered from physio practice they network with.
Post a Comment