Rapid Access Clinics: helping patients with low back, hip and knee pain get the right care

Spring 2020

Until recently, if you were suffering from lower back, hip or knee pain you had to wait many months to see a surgeon for a consultation; sometimes only to find out that surgery is not the best course of action, leading to a delay in receiving the most appropriate care for your condition.

Enter the Musculoskeletal (MSK) Rapid Access Clinics (RAC), which support patients waiting to see a surgeon for low back, hip and knee pain. As part of a regional initiative, the clinics at LHSC opened in 2019 to help patients get the right care at the right time by the right practitioner.

There are two types of RAC at LHSC: one for patients with low back pain and/or related leg pain, and another for patients with moderate to severe osteoarthritis related hip and knee pain. Patients are referred to a central intake by their physicians, and then triaged. Ideally patients have their initial appointment within four weeks of the referral.

At this initial appointment, patients see an Advanced Practice Provider who provides an assessment to ensure the patient is placed on the best care path. Presently these providers are physiotherapists with advanced training working with the surgical teams, though they can also be occupational therapists, chiropractors or nurse practitioners.

Following assessment, patients may be discharged, referred to another care provider such as a physiotherapist, or referred on for further assessment or investigation with a surgeon or other specialist. Patients who need further assessment or a surgical consult know what to expect and what steps they can take to help improve their outcomes. When meeting with the Advanced Practice Provider, patients have the option to choose the next available surgeon, or the surgeon or facility of their choice, while knowing the wait times associated with both.

Patients are benefiting from rapid assessment and receiving the therapy needed when it can be most impactful, with the goal of reducing unnecessary imaging, and helping to avoid opioid use and misuse through earlier intervention and education.

Currently, all hip and knee patients with moderate to severe osteoarthritis are seen by the Rapid Access Clinic. However, only a portion of the spine surgeon’s population are seen; those who are experiencing low back pain and low back related leg pain.

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From left to right – Brent Cunning, Advanced Practice Provider and Ravi Rastogi, Advanced Practice Lead with the Low Back Pain Rapid Access Clinic at LHSC.