Margit Kooijman

General Introduction | 17 Aim and scope In this thesis, we opt for a pause for reflection on the current management of shoulder pain in primary care in order to enable ourselves to decide wisely on the way forward. By asking the question ‘where are we now?’ we will explore some leads to improve care for patients with shoulder pain by physiotherapists and general practitioners. Three parts are considered: I Process and content of care • What are the characteristics of the patient population and care process in patients with shoulder syndromes in general and in physiotherapy practice? (Chapter 2) • Does the population and care process differ between patients treated solely by their GP, those referred for physiotherapy and self-referrals? (Chapter 2) • Do general practitioners and physiotherapists agree on the best management for four common shoulder complaints? (Chapter 3) II Diagnosis and prognosis • What is the diffusion of musculoskeletal ultrasound in Dutch physiotherapy practices? (Chapter 4) • What are the experiences of physiotherapist with MSU in a primary care setting in patients with shoulder complaints? (Chapter 4) • Which factors have prognostic value on (un)favourable outcome in patients with shoulder complaints in primary care, secondary care and occupational settings? (Chapter 5) III Context factors • Is there a therapist effect in physiotherapists treating patients with shoulder pain? (Chapter 6) • Do personality traits of the physiotherapist influence patient outcome? (Chapter 6) Chapter 7 comprises a general discussion on the findings of this thesis.