Table 3.
Management of warning flags in physical therapy practice.
| Physical therapists | PTMS | PTF | PTO | PTFO | Total |
|---|---|---|---|---|---|
| n = 84 | n = 74 | n = 142 | n = 110 | N = 410 | |
| (20.5%) | (18.1%) | (34.6%) | (26.8%) | (100%) | |
| Red Flag Management | |||||
| Refer to physician without physical therapy interventiona | 38 (45.2%) | 46 (62.2%) | 76 (53.5%) | 56 (50.9%) | 216 (52.7%) |
| Refer to physician with physical therapy intervention | 45 (53.6%) | 24 (32.4%) | 64 (45.1%) | 47 (42.7%) | 180 (43.9%) |
| Refer to MD with or without PT Intervention | 79 (94.0%) | 67 (90.5%) | 136 (95.8%) | 101 (91.8%) | 383 (93.4%) |
| Orange Flag Management | |||||
| Refer to Psychologist & address negative affective tendenciesa | 16 (19.0%) | 20 (27.0%) | 41 (28.9%) | 40 (36.4%) | 117 (28.5%) |
| Refer to Psychologist | 61 (72.6%) | 60 (81.1%) | 110 (77.5%) | 90 (81.8%) | 321 (78.3%) |
| Education to address negative affective tendencies | 24 (28.6%) | 23 (31.1%) | 49 (34.5%) | 51 (46.4%) | 147 (35.9%) |
| Yellow Flag Management | |||||
| No referral & education to address negative affective tendenciesa | 19 (22.6%) | 32 (33.8%) | 67 (47.2%) | 66 (60.0%) | 177 (43.2%) |
| Education to address negative affective tendencies | 27 (32.1%) | 32 (43.2%) | 84 (59.2%) | 76 (69.1%) | 219 (53.4%) |
| Referral to physician | 29 (34.5%) | 20 (27.0%) | 28 (19.7%) | 18 (16.4%) | 95 (23.2%) |
| Referral to psychologist | 00 (0.0%) | 04 (5.4%) | 05 (3.5%) | 03 (2.7%) | 12 (2.9%) |
PTF = fellow of orthopaedic manual therapy, PTO = orthopaedic clinical specialist, PTMS = physical therapist with musculoskeletal interest, PTFO = PT with both fellowship and orthopaedic clinical specialization, and LBP = low back pain.
a
Appropriate decision for patient vignette. Note that the numbers in the columns for each flag management option (red, orange or yellow) do not add up to 100% the clinical decisions are not mutually exclusive.