The Impact Of Provider Primary Specialty, Gender, And Experience On Treatment Recommendations In Sports Medicine

PURPOSE: The aim of this study is to evaluate acute musculoskeletal injury treatment differences based on primary care sports medicine physician characteristics. METHODS: Retrospective review of treatment provided at a walk-in orthopedic clinic was extracted by chart review. Treatment patterns were compared by Fisher’s exact test or Chi square test including primary specialty (Emergency Medicine, EM and Family Medicine, FM), gender, and years of experience. Treatment options evaluated were advanced imaging, medications, injections, physical therapies, durable medical equipment (DME), activity restrictions, and surgery or follow up. RESULTS: 80 patient encounters were included; 65 received care from FM or EM providers. FM physicians prescribed medication more frequently than EM physicians (n = 39, 46.2% vs. n = 26, 3.8%, p = 0.0002). There were no significant differences between frequency of recommendations for additional imaging, injection, physical therapy, stabilization, activity restrictions, surgery or follow up between FM and EM physicians. Male physicians prescribed medication more frequently than female physicians (n = 44, 50% vs. n = 36, 14.3%, p = 0.001). When comparing years of experience, physicians in the first 5 years of practice recommend less physical therapy (p = 0.02) and activity modifications (p = 0.002) than providers with 5-20+ years of experience. Physicians in their first 5 years of practice recommended physical therapy 16% of the time and change in activity 4% of the time vs. physicians with 5-20+ years of experience recommended physical therapy 33.3-62.5% of the time and activity modifications 37.5-61.1%. No significant differences in treatment recommendations based on patient age or gender were observed. CONCLUSIONS: Data suggests there are differences in documented treatment recommendations based on the residency completed prior to sports medicine fellowship, provider gender, and experience. Specifically, FM physicians and male physicians prescribe medication more frequently, and physicians with more experience recommend physical therapy and activity modification more frequently than physicians with fewer years of experience. Correlation of treatment trends with patient outcomes may identify areas for enhanced training to limit outcome discrepancies.