SGH, TTSH and NUH have put physiotherapists on standby at A&E, saving time for patients and doctors.
After struggling with pain from a torn ligament for two weeks, Mr Gerry Gewi turned up at the accident and emergency (A&E) department of Tan Tock Seng Hospital (TTSH).
The 37-year-old could not walk and had little faith in physiotherapy. But the A&E doctor told him it was a good option for him, and the hospital activated senior physiotherapist Jason Loh, who was on standby.
Instead of being warded or sent home with painkillers, Mr Gewi had his foot massaged by Mr Loh, who got the blood flowing before asking him to put weight on it.
“I walked and it was a good feeling,” Mr Gewi said. “I was wheeled into the hospital, but I walked out.”
Singapore General Hospital (SGH) and the National University Hospital (NUH) have also opted to have physiotherapists on call for patients in the A&E department.
Physiotherapists at TTSH treated over 900 patients under this A&E programme between June 2015 and October last year. The corresponding figure for SGH, which started the service in 2012, is around 3,500, while the NUH team sees about two or three elderly patients every day.
At TTSH and SGH, doctors first assess patients who have pain in their muscles and bones, or with symptoms like dizziness and vertigo, indicators of a relatively common inner-ear problem that a physiotherapist can resolve.
If necessary, the doctors refer these patients to the physiotherapist on duty for treatment. The NUH programme is similar, although it focuses on elderly patients.
Said NUH emergency medicine specialist Sim Tiong Beng: “As a result, these patients can be discharged from the department safely on the same day, unlike in the past when they would have been admitted for such services.”
Mr Loh said the patient benefits from having immediate treatment. “When someone who sprains his ankle does not use his leg for two weeks, it stiffens and the muscle starts to waste. It’s harder to undo what has already been done.”
Getting physiotherapists involved in treating such uncomplicated cases also frees up doctors’ time, said Ms Jennifer Liaw, who heads SGH’s physiotherapy department.
“Many who are afflicted with sudden back pains and the like may need only some form of physiotherapy before being discharged from the A&E,” she added. “Expediting their care at that point also allows emergency medicine doctors to devote time to those with more serious conditions.”
Having a physiotherapist on standby also means patients do not have to wait two to three weeks for an outpatient appointment.
The experts stressed that as a general rule, people should see a polyclinic doctor or general practitioner first, and not go straight to the A&E department.