Margit Kooijman

Shoulder vignettes | 51 highly recommended so that more specific recommendations can be created on adequate keep/refer decision making. A last aspect to take into consideration is the relatively low response rate, which could impair generalisability. Non-response analysis showed only minor differences in gender but other characteristics such as years of clinical experience or education were not available for comparison. The absolute number of participants, i.e. 84 GPs and 110 physiotherapists give some assurance that the global approach of both disciplines has been adequately measured. The response rates were also in the same range as the previous study by Buchbinder et al. (2013) 15 . As well, they found no differences in management between general practitioners with and without education on musculoskeletal complaints. In summary, 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 clinicians generally agreed 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. Given the unfavourable outcome in many patients, especially in patients with high and/or persisting pain, 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.