Letters | Meaningful direct access to physiotherapy is still elusive
Readers discuss the bottlenecks delaying musculoskeletal pain management in Hong Kong, and tougher tobacco controls
In principle, direct access means that someone with persistent shoulder pain can book a physiotherapist for assessment, treatment and advice and be referred to a doctor if red flags appear. In practice, the current framework relies on tightly defined pathways that exclude many ordinary cases.
First, patients may need documentation of a recent diagnosis dated within the past 12 months.
Second, direct access applies to a list of recognised problems, which has been widely described as focusing in effect on knee osteoarthritis and low back pain. Many common complaints people bring to physiotherapists, such as shoulder, neck, wrist, hip and ankle pain, are not clearly listed.
Third, access can depend on whether patients have enrolled in District Health Centre services and eHealth and been matched with a family doctor; a first-contact physiotherapist would also need to have enrolled in the Primary Health Care Directory.