Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
Spine (Phila Pa 1976). 2013 Apr 1;38(7):E402-8. doi: 10.1097/BRS.0b013e318286c96b.
Questionnaire survey.
To explore spine surgeons' attitudes toward the involvement of nonphysician clinicians (NPCs) to screen patients with low back or low back-related leg pain referred for surgical assessment.
Although the utilization of physician assistants is common in several healthcare systems, the attitude of spine surgeons toward the independent assessment of patients by NPCs remains uncertain.
We administered a 28-item survey to all 101 surgeon members of the Canadian Spine Society, which inquired about demographic variables, patient screening efficiency, typical wait times for both assessment and surgery, important components of low back-related complaints history and examination, indicators for assessment by a surgeon, and attitudes toward the use of NPCs to screen patients with low back and leg pain referred for elective surgical assessment.
Eighty-five spine surgeons completed our survey, for a response rate of 84.1%. Most respondents (77.6%) were interested in working with an NPC to screen patients with low back-related complaints referred for elective surgical assessment. Perception of suboptimal wait time for consultation and poor screening efficiency for surgical candidates were associated with greater surgeon interest in an NPC model of care. We achieved majority consensus regarding the core components for a low back-related complaints history and examination, and findings that would support surgical assessment. A majority of respondents (75.3%) agreed that they would be comfortable not assessing patients with low back-related complaints referred to their practice if indications for surgery were ruled out by an NPC.
The majority of Canadian spine surgeons were open to an NPC model of care to assess and triage nonurgent or emergent low back-related complaints. Clinical trials to establish the effectiveness and acceptance of an NPC model of care by all stakeholders are urgently needed.
问卷调查。
探讨脊柱外科医生对非医师临床医生（NPC）参与筛选因下腰痛或与下腰痛相关的腿痛而接受手术评估的患者的态度。
尽管在多个医疗保健系统中使用医师助理很常见，但脊柱外科医生对 NPC 独立评估患者的态度仍不确定。
我们向加拿大脊柱学会的 101 位外科医生成员发放了一份包含 28 个项目的调查问卷，调查内容包括人口统计学变量、患者筛查效率、评估和手术的典型等待时间、下腰痛相关病史和检查的重要组成部分、评估的指征以及对使用 NPC 筛查因选择性手术评估而转诊的下腰痛和腿痛患者的态度。
85 位脊柱外科医生完成了我们的调查，应答率为 84.1%。大多数受访者（77.6%）有兴趣与 NPC 合作，筛选因选择性手术评估而转诊的下腰痛相关患者。认为咨询等待时间不理想和对手术候选人的筛查效率差与外科医生对 NPC 护理模式的更大兴趣相关。我们就下腰痛相关病史和检查的核心内容以及支持手术评估的发现达成了多数共识。大多数受访者（75.3%）同意，如果 NPC 排除了手术指征，他们会感到舒适，不会评估转介到他们诊所的下腰痛相关患者。
大多数加拿大脊柱外科医生对 NPC 护理模式持开放态度，以评估和分诊非紧急或紧急下腰痛相关投诉。迫切需要进行临床试验，以确定所有利益相关者对 NPC 护理模式的有效性和接受程度。
