Insights into the complexity of presentation and management of patients: the Sport and Exercise Physician's perspective

Prasanna J Gamage; Saran Seker; Jessica Orchard; David Humphries; Kylie Fitzgerald; Jane Fitzpatrick

doi:10.1136/bmjsem-2021-001228

Insights into the complexity of presentation and management of patients: the Sport and Exercise Physician's perspective

BMJ Open Sport Exerc Med. 2021 Nov 26;7(4):e001228. doi: 10.1136/bmjsem-2021-001228. eCollection 2021.

Authors

Prasanna J Gamage^{1

2}, Saran Seker¹, Jessica Orchard³, David Humphries^{1

4}, Kylie Fitzgerald^{1

5}, Jane Fitzpatrick^{1

6}

Affiliations

¹ Australasian College of Sport and Exercise Physicians, Melbourne, Victoria, Australia.
² School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
³ Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, New South Wales, Australia.
⁴ School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
⁵ School of Health & Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.
⁶ Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.

Abstract

Objectives: Sport and Exercise Physicians represent a relatively new specialty focusing on exercise in complex diseases including musculoskeletal diseases. Our objective was to describe the characteristics, type and complexity of patient presentations, their management strategies and referral information in Australian practice.

Methods: A cross-sectional study including a cohort of 11 senior Sport and Exercise Physicians in Australia studied all new patient consultations within an 8-week period. Data were analysed relating to presentation, referral source, follow-up referrals, and patient management strategies.

Results: Data from 419 patients were recorded. The majority, 97% (n=406), had musculoskeletal conditions, 53% (n=222) had one or more associated comorbidities and 47% (n=195) had ongoing symptoms for >12 months. Most patients, 82% (n=355), were referred by general practitioners. Prior consultations included physiotherapy 72% (n=301) and orthopaedic 20% (n=85). A multidisciplinary network of referrals from Sport and Exercise Physicians was observed, including 210 referrals to 9 allied health specialities and 61 referrals to 17 medical specialities. Over 74% (n=311) of patients received exercise-based intervention as part of the treatment plan, including 57% (n=240) physician managed exercise interventions.

Conclusion: Our work shines a light on the nature and complexity of the role of Sport and Exercise Physicians in an Australian practice context. Findings will assist in implementing measures to promote patient care at the community level in managing musculoskeletal conditions. Sport and exercise medicine stakeholders and government policy makers can use this information in developing appropriate programmes to support patients and create integrated sport and exercise medicine services for the community.

Keywords: health promotion; physician; sports & exercise medicine; sports medicine.