Attention to musculoskeletal diseases. Different visions of the same problem.

OBJECTIVE To identify the main problems affecting general practitioners (GPs) and specialists in the care of the main musculoskeletal problems in Catalonia. METHOD Cross-sectional, self-administered survey in a representative sample of GPs and all specialists in four areas (orthopedic surgery, rheumatology, physical medicine and rehabilitation and pain units). Variables evaluated in the survey were related to socio-demographic data, attention to musculoskeletal diseases, self-declared expertise, referral process, coordination mechanisms and major constraints to provide high quality care. RESULTS GPs value well their expertise in the management of musculoskeletal diseases (6,7±1,0 on a scale of 1 to 10). Less than 25% of GPs are coordinated with hospital specialists. For them, waiting lists are the main problem (8.2±1,6/10) followed by lack of feedback (8±1,9/10) and poor coordination (7.8±1,9/10). Referenced specialties should change for some diseases (back pain and osteoarthritis). Specialists are critical for GPs. For specialists, the main problems are excessive workload (7,8±2/10) and the inefficiency of healthcare information systems (7.4±2/10). CONCLUSIONS The vision of the problems affecting the care of musculoskeletal diseases differs between GPs and hospital specialists. The limited accessibility and workload excess, deficiencies in the flow of information and poor coordination are the most important problems in the proper care for musculoskeletal diseases.