In a landscape where healthcare systems are under constant strain, ensuring that patients receive appropriate care in a timely manner is crucial. The recent study by Axén, Schriwer, and Hjertstrand delves into this very issue, exploring the critical role of manual therapists in triaging patients who present with back and neck pain. This is a topic of growing relevance, given that musculoskeletal disorders are among the leading causes of disability globally. The findings of this qualitative study provide insightful perspectives on how manual therapists can serve as gatekeepers in primary care settings, potentially enhancing the overall efficiency of healthcare systems.
The concept of gatekeeping in healthcare refers to the process through which certain healthcare providers regulate patient access to more specialized services. In many cases, manual therapists, including physiotherapists and chiropractors, are the first point of contact for patients experiencing musculoskeletal issues. The researchers argue that the role of these professionals is often underestimated, even though they possess critical skills in assessing and routing patients to the appropriate level of care. The manual therapists interviewed in this study highlighted their experiences and strategies in managing patients with back and neck pain, shedding light on the essential skills they bring to primary care.
A central theme in the study is the importance of effective communication between manual therapists and other healthcare providers. The therapists emphasized that their role extends beyond treatment to include patient education and guidance, helping patients understand their conditions and the potential pathways for managing pain. This therapeutic relationship is vital, as it fosters trust and encourages patients to engage proactively in their care, rather than merely relying on medical prescriptions. The qualitative nature of this study allows for a nuanced understanding of these interactions, as therapists shared personal anecdotes and reflections on their practice.
Moreover, the study addresses the various challenges manual therapists face within the healthcare system. Many therapists reported feeling underutilized in their capacity as gatekeepers, often encountering patients who have been directly referred to specialists without an initial assessment by a manual therapist. This not only delays effective intervention but also places additional pressure on specialized services that may already be overwhelmed. The participants described a scenario where timely triaging could prevent the deterioration of a patient’s condition, ultimately improving health outcomes and resource allocation.
The interplay between clinical knowledge and patient management strategies emerged as a significant factor in the study. Manual therapists bring a unique skill set to patient assessments. They are trained to evaluate physical conditions from a holistic perspective, considering both biomechanical and lifestyle factors. This comprehensive approach enables them to identify potential red flags that may indicate the need for further investigation. As gatekeepers, they can triage patients effectively, ensuring that those who require specialized intervention are referred appropriately.
An essential takeaway from the research is the need for better integration of manual therapists into the broader healthcare framework. By recognizing their expertise, healthcare systems can optimize patient flow and resource utilization. The authors suggest that a collaborative model, where manual therapists are acknowledged as primary care providers, could significantly enhance patient care. This model would not only benefit patients but also reduce the burden on physicians and specialists, enabling a more sustainable healthcare system.
Interestingly, the study reveals the potential for manual therapists to play a pivotal role in preventive care. By engaging with patients early in the course of their symptoms, manual therapists can implement strategies that reduce the risk of chronic pain development. This preventative aspect aligns with the growing emphasis on proactive health management, as early intervention can lead to better long-term outcomes and lower healthcare costs. The therapists’ unique positioning allows them to educate patients on self-management strategies, promoting personal responsibility in health.
As healthcare continues to evolve, there is also a call for further research into the impact of manual therapists on patient outcomes. The qualitative insights gathered from this study highlight the need for quantitative studies to support the role of manual therapists as gatekeepers. Establishing evidence-based models can facilitate policy changes that integrate manual therapists more deeply into primary care frameworks, ultimately benefiting both patients and the healthcare system as a whole.
The study’s implications extend beyond individual practitioners and patients, prompting a broader conversation about the structure and functionality of primary care. With healthcare costs rising globally, finding innovative solutions becomes imperative. Manual therapists could play an integral role in alleviating some of the pressure on conventional healthcare pathways, ensuring that patients receive timely and appropriate care without unnecessary delays or complications.
In conclusion, this qualitative study offers a valuable perspective on the role of manual therapists as gatekeepers in primary care. It emphasizes the need for greater acknowledgment of their expertise and the benefits of their involvement in patient triaging. As healthcare systems continue to adapt to ever-changing demands, integrating manual therapists into primary care settings could provide a more efficient approach to managing musculoskeletal disorders and improving patient outcomes.
The insights gained from Axén, Schriwer, and Hjertstrand’s research underscore a pathway toward a more collaborative healthcare model, one that ultimately prioritizes patient well-being while optimizing resource allocation. As the conversation surrounding healthcare accessibility and efficiency grows, the role of manual therapists as essential gatekeepers cannot be overlooked.
Subject of Research: The role of manual therapists in primary care for triaging patients with back and neck pain.
Article Title: Gatekeepers in primary care – a qualitative study on manual therapists’ role in triaging patients with back and neck pain.
Article References: Axén, I., Schriwer, E., Hjertstrand, J. et al. Gatekeepers in primary care – a qualitative study on manual therapists’ role in triaging patients with back and neck pain. BMC Health Serv Res 25, 1413 (2025). https://doi.org/10.1186/s12913-025-13593-w
Image Credits: AI Generated
DOI: 10.1186/s12913-025-13593-w
Keywords: manual therapy, primary care, triage, back pain, neck pain, qualitative research, healthcare integration, patient outcomes.
