Physiotherapists' experiences of direct access for clients with musculoskeletal pain and dysfunction: a qualitative study

Aims: The aim of this study was to qualitatively analyse physiotherapists' experiences and perspectives for delivering services directly, without prescription or referral, for clients with musculoskeletal pain or dysfunction. Methods: This was a qualitative study where data were collected from questionnaires given to 34 physiotherapists, 18 of them being in direct access for 6 years and 16 for 6 months. There were 15 structured questions and 3 open-ended ones. The answers were analysed with quantitative and qualitative methods. Results: The data analysis of the open-ended questions showed that physiotherapists had positive experiences of direct access. This practice brought meaningfulness, including increased self-respect, to physiotherapists' work. Meaningfulness was interpreted as being constructed from a client perspective, a work perspective and a working community perspective. The self-respect was connected to experiencing the improvement of skills with their clients. Conclusions: In providing direct access practice, physiotherapists expressed a heightened sense of meaningfulness in their work, which was related to clients' satisfaction with being in the right place at the right time. They experienced improved competence, which was connected with their self-respect and cooperation with other health care professionals. For future research, we propose to explore of larger samples of physiotherapists, clients and other key stakeholders.