Non-surgical Orthopaedic Physician FAQs
What is the non-surgical orthopaedic physician demonstration?
Auckland District Health Board (ADHB) is being supported by Health Workforce New Zealand (HWNZ) to demonstrate the role of non-surgical orthopaedic physician at Starship Children’s Hospital (SCH). The new role aims to manage non-surgical referrals, thereby releasing valuable surgeon time.
The objective of the project is to demonstrate the role of non-surgical orthopaedic physicians and to develop protocols to enable other practitioners to provide paediatric orthopaedic services that do not require surgical interventions and who can identify cases where surgical intervention are more likely to be required.
Specifically the demonstration aims to:
- Demonstrate the role of non-operative paediatric orthopaedic physician;
- Develop protocols for advanced physiotherapists or general practitioners with a special interest to provide similar services in future;
- Train general practitioners and physiotherapists in providing non-surgical orthopaedic services.
What is a non-surgical orthopaedic physician and what do they do?
A non-surgical orthopaedic physician is a general paediatrician who has completed their one year fellowship training in non-operative orthopaedics in an orthopaedic department.
During the demonstration, the physician will have a dual function, a 50:50 split in time. The first half of the role will be service provision. The physician will provide regular clinics for first specialist appointments (FSAs) and follow up appointments.
The other half of the role will be developing the non-surgical orthopaedic physician role to ensure sustainability including identifying the initial and on-going education needs for the position and working collaboratively with the paediatric orthopaedic department to establish clinical guidelines for the effective triage and management of lower priority referrals.
Why do we need this role?
The paediatric orthopaedic service at SCH receives over 2000 referrals per year from primary care. Despite a rigorous triage process where 30% of primary care referrals are declined, the service is not able to keep pace with demand.
The department sees a considerable volume of children that don’t require surgical intervention; approximately only 5% of children who have a first specialist appointment (FSA) go on to have surgery. Quite often, children require musculoskeletal assessment and parents require reassurance of the child’s development as well as information on normal child growth and development as it pertains to the musculoskeletal system.
Seeing a large number of children with non-surgical or minor orthopaedic conditions referrals is an inefficient and costly use of an orthopaedic surgeon’s time, which causes delays in timely access to the department and places a heavy demand on the surgeon’s time.
This workload may be better managed by the use of a non-operative physician type role.
When will the demonstration start?
The demonstration commenced in July 2011 and will finish in December 2011.
Are we likely to see this role in other settings?
We are likely to see the development of the non-surgical orthopaedic practitioner role in community settings and the demonstration will develop protocols for advanced physiotherapists or general practitioners with a special interest, to provide non-surgical orthopaedic services.
How will the demonstration be monitored?
A local researcher will provide reports throughout the demonstration and on completion of the demonstration.
The report will discuss the efficacy of the non-surgical orthopaedic physician role and determine the suitability/acceptability of such a position in the New Zealand health environment. Specifically the evaluation will determine:
- any reduction in numbers of unnecessary appointments with orthopaedic surgeons
- any reduction in waiting list times for paediatric orthopaedic services
- any increase in throughput for paediatric services
- any change in service quality.