Margit Kooijman

Abstract Introduction Patients with shoulder complaints are commonly seen in primary care general and physiotherapy practice. Despite increasing literature, clinicians still face many uncertainties in treating these complaints, resulting in unfavourable prognosis for many patients. By comparing general practitioners and physiotherapists’ management to each other, leads are established to improve treatment of patients with shoulder pain in primary care. Methods A questionnaire was sent to a random sample of 500 general practitioners and 500 physiotherapists, recruited from the national register databases for general practitioners and physiotherapists of the Netherlands Institute for Health Services Research. Each questionnaire consisted of four vignettes representing four common shoulder problems: rotator cuff tendinopathy, acute rotator cuff tear and early and late presentation of adhesive capsulitis. Clinicians were asked to indicate what management options they would routinely advocate. Results The net response rate of general practitioners was 16.9% and of physiotherapists 24.0%. The degree to which general practitioner and physiotherapist management correspond with each other seems to depend on the type of shoulder pain involved. With subacromial complaints or an acute rotator cuff tear, the majority of both groups of clinicians generally agree on the preferred treatment. The scenario of the patient with capsulitis, especially the late presentation, caused much more variation in responses both between and within groups. Conclusion Further research on adequate keep/refer decision making as well as more attention for psychosocial issues could be important topics in order to improve treatment.