Emergency physicians' perspectives on integrating physiotherapists into emergency departments: a national survey from France.

Background: Emergency departments (EDs) worldwide are facing increasing patient volumes and thus crowding, prolonged waiting times and rising healthcare costs. In France, ED visits rose from 8.5 to 16 million between 2014 and 2024. To address these challenges, several countries (including Australia, the UK and Canada) have integrated physiotherapists into EDs in advanced practice roles-primarily for musculoskeletal (MSK) conditions. In contrast, this type of integration is rare in the French healthcare system. The objective of the present study was to assess the attitudes of French emergency physicians to the incorporation of physiotherapists into ED teams.

Methods: A nationwide, cross-sectional survey of emergency physicians practising in France was conducted between 22 November 2023 and 15 February 2024. The study questionnaire assessed the physicians' willingness to collaborate with physiotherapists, the perceived benefits of collaboration and views on task delegation. Descriptive statistics and χ² tests were used to analyse the data.

Results: Of the 420 respondents, 333 (79.3%) expressed willingness to collaborate with physiotherapists in EDs. The most commonly cited benefits were improved quality of care n=321 (76.4%), greater patient satisfaction n=318 (75.7%), a lower physician workload n=276 (67.5%) and enhanced ED efficiency n=211 (50.2%). The conditions most frequently considered for delegation included suspected ankle sprains n=313 (74.5%), knee sprains n=277 (66.0%) and lower back pain n=271 (64.5%). Compared with junior colleagues, senior physicians with five or more years of experience were significantly more supportive of delegating cases of neck pain (n=110, 41.7%, p=0.017).

Conclusions: French emergency physicians are generally supportive of integrating physiotherapists into EDs, especially for the management of non-urgent MSK conditions. The physicians see physiotherapists as capable of providing on-site care and patient education, potentially improving patient flow and alleviating pressures in overcrowded EDs. These findings offer valuable insights for countries in which the integration of physiotherapy into emergency care is still emerging.