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| {{format references|date=August 2019}} | | {{Short description|A healthcare professional specializing in spine care}} |
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| {{Infobox occupation
| | ==Overview== |
| | name = Primary spine practitioner
| | A '''Primary Spine Practitioner''' (PSP) is a healthcare professional who specializes in the diagnosis, management, and treatment of spine-related disorders. PSPs are trained to provide comprehensive care for patients with [[spinal disorders]], including [[back pain]], [[neck pain]], and other musculoskeletal conditions affecting the spine. They serve as the first point of contact for patients with spine-related issues and coordinate care with other healthcare providers as needed. |
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| | official_names = PSP, Spine Care Clinician, or Spine Care Specialist
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| | type = Health care professional
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| '''Primary spine practitioners''' (also referred to as '''PSP''', '''Spine Care Clinician''', or '''Spine Care Specialist''', or in the broader context a '''primary musculoskeletal specialist''' or '''provider''') are health care professionals who are specially trained to provide [[primary care]] for patients with [[spinal disease]].<ref name="Haldeman 2009">{{cite book|last=Haldeman|first=S.|chapter=Looking Forward|editor-last=Phillips|editor-first=RB|title=The Journey of Scott Haldeman, Spine Care Specialist and Researcher|location=Des Moines, Iowa|publisher=National Chiropractic Mutual Holding Company|isbn=1880759-90-X|date=2009|url-access=registration|url=https://archive.org/details/journeyofscottha00}}</ref><ref name="Murphy 2011" />
| | ==Role and Responsibilities== |
| The PSP has the training necessary to provide [[differential diagnosis]], rule out serious pathology (such as infection, fracture, cancer, inflammatory joint disease) and provide evidence-based management for the majority of patients with spinal disease. [[Evidence-based medicine|Evidence-based]] treatment methods include [[spinal manipulation]] and [[manual therapy]], rehabilitative exercises, patient education, motivational techniques and the application of psychological principles, particularly those of [[cognitive-behavioral therapy]] and [[acceptance and commitment therapy]].<ref name="Murphy 2011" /><ref name="Murphy 2013">{{cite book|last=Murphy|first=DR|title=Clinical Reasoning in Spine Pain Volume I: Primary Management of Low Back Disorders Using the CRISP Protocols|location=Pawtucket, RI|publisher=CRISP Education and Research|date=2013|oclc=933296076|isbn=9780615888576 }}</ref>
| | Primary Spine Practitioners are responsible for: |
| In addition, the PSP has the ability to recognize the relatively few patients who require special tests ([[radiography]], [[Magnetic resonance imaging|MRI]], laboratory workup) and invasive procedures (injections, surgery) and to serve as the center of care for the purpose of providing counseling for the patient, coordination of care and long term follow up.<ref name="Haldeman 2009" /><ref name="Murphy 2011">{{cite journal|last=Murphy|first=DR|last2=Justice|first2=BD|last3=Paskowski|first3=IC|last4=Perle|first4=SM|first5=MJ|last5=Schneider|title=The establishment of a primary spine care practitioner and its benefits to health care reform in the United States|journal=Chiropractic & Manual Therapies|date=2011|pmid=21777444|doi=10.1186/2045-709X-19-17|volume=19|issue=1|page=17}}</ref>
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| An important aspect of this role is educating the patient on the risks, benefits and research evidence of all treatments for spinal pain so that, through a shared decision making process,<ref name="McGill 2013">{{cite journal|last=McGill|first=T.|title=Effectiveness of physical therapists serving as primary care musculoskeletal providers compared to family practice providers in a deployed combat location: A retrospective medical chart review|journal=Military Medicine|date=2013|volume=178|issue=10|page=1115|doi=10.7205/MILMED-D-13-00066|pmid=24083925}}</ref> appropriate choices can be made as to what is the best treatment for the patient.
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| In addition, the PSP is tasked with helping the patient navigate the often-complex social systems, particularly for patients whose spinal disease arose from a work-related incident or personal injury.
| | * Conducting thorough [[clinical assessments]] to diagnose spine-related conditions. |
| | * Developing and implementing individualized [[treatment plans]] for patients. |
| | * Providing [[patient education]] on spine health and preventive measures. |
| | * Coordinating care with other healthcare professionals, such as [[physical therapists]], [[chiropractors]], and [[orthopedic surgeons]]. |
| | * Monitoring patient progress and adjusting treatment plans as necessary. |
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| == History == | | ==Training and Qualifications== |
| | PSPs typically have advanced training in spine care, which may include: |
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| The concept of a spine care clinician or practitioner was first presented by Scott Haldeman, neurologist, in an editorial in [[The Spine Journal]] in 2001<ref name="Haldeman 2001">Haldeman S. Assisting patients in their choice of treatment options: a primary goal of all spine care clinicians. The Spine Journal 2001, 1:307</ref> to include all clinical specialties that treat patients with spinal disease. This was emphasized at the American Back Society Annual Convention in San Francisco in November 2005.<ref name="Haldeman 2005">Haldeman S. Surviving the Era of Evidence Based Guideline. Presentation at the American Back Society annual convention. San Francisco, November, 2005</ref> At that time it was clear that none of the current clinical disciplines offering care to people with spinal disorders were adequately trained in the skills necessary to offer treatment protocols consistent with current evidence-based guidelines. The necessity to define a primary spine care clinician or specialist became even more evident when it was determined that there were over 200 treatment approaches available for people with spinal pain without any clinician with the knowledge, time, skills and ability to guide patients through this maze of treatment options.<ref name="Haldeman 2009" /><ref name="Haldeman 2008">Haldeman S. A supermarket approach to the evidence-informed management of chronic low back pain. The Spine Journal 2008, 8:1</ref>
| | * A background in [[physical therapy]], [[chiropractic care]], or [[medicine]]. |
| Similar considerations were presented in the [[British Medical Journal]] by Harvigsen et al. which noted that the general medical practitioner is not adequately equipped to deal with the complexities of musculoskeletal disorders and suggested that the solution to this problem would be the development of a primary musculoskeletal specialist.<ref name="Hartvigsen 2011">Hartvigsen J, Foster NE, Croft PR. We need to rethink front line care for back pain. BMJ 2011;342:d3260</ref> Hartvigsen et al. suggested that [[chiropractor]]s, [[physical therapist]]s or [[osteopathic physician]]s could serve this purpose with some changes in education, clinical practice and licensure of these professions.
| | * Specialized training programs or certifications in spine care. |
| | * Continuing education to stay updated on the latest research and treatment techniques in spine health. |
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| This has not gone unrecognized by these professions with a series of articles now appearing in [[chiropractic]]<ref name="Murphy 2011" /><ref name="Murphy 2013" /> and [[physical therapy]] journals <ref name="Erwin 2013">Erwin WM, Korpela AP, Jones RC Chiropractors as Primary Spine Care Providers: precedents and essential measures. J Can Chiropr Assoc 2013; 57</ref> suggesting that their professions are capable of assuming this role in the health care system and recommending that education and standards of practice be adopted so that their practitioners are in a position to assume this role in the future.
| | ==Scope of Practice== |
| | The scope of practice for a Primary Spine Practitioner includes: |
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| == References ==
| | * Non-surgical management of spine-related conditions. |
| {{reflist}}
| | * Use of manual therapy techniques, such as [[spinal manipulation]] and [[mobilization]]. |
| | * Prescription of [[therapeutic exercises]] and [[rehabilitation programs]]. |
| | * Guidance on lifestyle modifications to improve spine health. |
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| [[Category:Chiropractic]] | | ==Benefits of Primary Spine Practitioners== |
| [[Category:Physical therapy]] | | The involvement of PSPs in spine care offers several benefits, including: |
| [[Category:Osteopathy]] | | |
| [[Category:Osteopathic medicine]] | | * Improved access to specialized care for patients with spine-related issues. |
| [[Category:Allied health professions]] | | * Reduction in unnecessary [[diagnostic imaging]] and [[surgical interventions]]. |
| [[Category:Osteopathic manipulative medicine]] | | * Enhanced coordination of care among different healthcare providers. |
| [[Category:Manual therapy]] | | * Increased patient satisfaction and outcomes through personalized care. |
| [[Category:Musculoskeletal disorders]] | | |
| [[Category:Alternative medicine]] | | ==Challenges and Considerations== |
| {{dictionary-stub1}}
| | While the role of PSPs is expanding, there are challenges to consider, such as: |
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| | * Variability in training and qualifications across different regions. |
| | * Need for increased awareness and recognition of the PSP role among healthcare providers and patients. |
| | * Integration of PSPs into existing healthcare systems and reimbursement models. |
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| | ==Related Pages== |
| | * [[Spinal disorders]] |
| | * [[Back pain]] |
| | * [[Neck pain]] |
| | * [[Physical therapy]] |
| | * [[Chiropractic care]] |
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| | [[Category:Healthcare occupations]] |
| | [[Category:Spinal disorders]] |
A healthcare professional specializing in spine care
Overview[edit]
A Primary Spine Practitioner (PSP) is a healthcare professional who specializes in the diagnosis, management, and treatment of spine-related disorders. PSPs are trained to provide comprehensive care for patients with spinal disorders, including back pain, neck pain, and other musculoskeletal conditions affecting the spine. They serve as the first point of contact for patients with spine-related issues and coordinate care with other healthcare providers as needed.
Role and Responsibilities[edit]
Primary Spine Practitioners are responsible for:
Training and Qualifications[edit]
PSPs typically have advanced training in spine care, which may include:
- A background in physical therapy, chiropractic care, or medicine.
- Specialized training programs or certifications in spine care.
- Continuing education to stay updated on the latest research and treatment techniques in spine health.
Scope of Practice[edit]
The scope of practice for a Primary Spine Practitioner includes:
Benefits of Primary Spine Practitioners[edit]
The involvement of PSPs in spine care offers several benefits, including:
- Improved access to specialized care for patients with spine-related issues.
- Reduction in unnecessary diagnostic imaging and surgical interventions.
- Enhanced coordination of care among different healthcare providers.
- Increased patient satisfaction and outcomes through personalized care.
Challenges and Considerations[edit]
While the role of PSPs is expanding, there are challenges to consider, such as:
- Variability in training and qualifications across different regions.
- Need for increased awareness and recognition of the PSP role among healthcare providers and patients.
- Integration of PSPs into existing healthcare systems and reimbursement models.
Related Pages[edit]
