Interprofessionalism in the health sector – the benefits of collaborative work between physician and physiotherapists in red flags screening

Background
In the healthcare sector, "red flags screening" is defined as recognising signs and symptoms of a possible serious pathology. These serious pathologies increase with age and the prevalence will rise accordingly in the coming years. Thus, the importance of early detection to ensure the best possible care is growing. Due to long patient interaction times, physiotherapists (PT) can play an important role in screening. For this purpose, creating a red flags training for PTs based on the literature and the experience of specialists (medical doctors [MDs], PT), is necessary. To develop this training, intensive collaboration between MDs and PTs is needed.
Methods
This reflection was conducted within a larger project, including five MDs, one Master student of Human Medicine and four PTs. Within 18 months, weekly to monthly meetings were held with the aim to develop new educational clinical cases of red flags. In the different phases of the project a list of relevant pathologies with thorough background information was compiled, and clinical cases based on real patients were developed and validated. Close collaboration between the two professions (MD and PT) was required to work efficiently and ensure a high-quality process. To disclose the benefits of this collaboration, written feedback of the individual team members was obtained, and further discussions were conducted by two representatives of both professions.
Results
The meetings enabled a deeper understanding of the needs of the other profession and respect these when decisions and additional information were discussed. Furthermore, the importance of “speaking the same language” became apparent. From the medical perspective, knowledge of the essential key factors needed for keep/refer decisions of PTs was gained. Besides the different use of terminology, the clinical-reasoning process revealed several overlaps. Awareness was raised for the lack of access to diagnostic tools in physiotherapy and thus the necessity to carry out these decisions with limited information. Furthermore, MDs perceptions about PT’ knowledge did not always match actual PT competences. On the physiotherapy side, the openness to improve communication and the exchange of expertise was highlighted. “A unique experience was the willingness of the physicians to pass on and share their knowledge” (PT member). Moreover, the realization was made that pathways to communicate red flags to MDs need to be more clearly defined.
Interpretation
Both medical as well as physiotherapeutic professionals see the need for a close collaboration when handling and improving the management of patients with a possible serious pathology. Throughout the project, knowledge of the respective other side was gained and open-mindedness for interdisciplinary work was emphasized. In future this reflection should be used to encourage interprofessional work in further projects concerning the challenges in the health sector.