Volume 191 - Issue 8
Back pain: a National Health Priority Area in Australia?
Authors: Victor J Wilk, Michael J Yelland and Michael B Oei
Med J Aust 2009; 191 (8): 469-471. || doi: 10.5694/j.1326-5377.2009.tb02892.x
Published online: 19 October 2009
Published online: 19 October 2009
To the Editor: On behalf of the Australian Association of Musculoskeletal Medicine (AAMM) and the Australasian Faculty of Musculoskeletal Medicine (AFMM), we would thank Briggs and Buchbinder for raising the topic of back pain as a National Health Priority Area (NHPA) for debate.1 The AAMM and its teaching arm, the AFMM, have been arguing for years that higher priority should be given to the management of low back pain, and we certainly support the arguments for making back pain an NHPA.
We agree that back pain is a major burden on society, and that coordinated action that includes all stakeholders is required. Currently, members of the AAMM and AFMM are involved in contributing to the Australian Core Competencies in Musculoskeletal Basic and Clinical Science project,2 which aims to standardise the undergraduate teaching in musculoskeletal medicine around Australia.
As well as supporting undergraduate initiatives, the AAMM and AFMM have been the significant providers of postgraduate education for doctors around Australia over the past 20 years, being engaged in activities that include the development of evidence-based guidelines and university-based postgraduate diploma and masters programs.3 It is then very disappointing to read disparaging comments about doctors with a special interest in musculoskeletal medicine.
Briggs and Buchbinder assert that one potential disadvantage of making back pain a health priority is that it may provide “justification for those with . . . vested interests to promote clinically ineffective interventions”. The example they cite is a questionnaire survey of Victorian doctors in 2004, highlighting that a self-reported interest in low back pain or musculoskeletal medicine, or both, was strongly associated with back pain management beliefs and practices that are contrary to the best available evidence.4
The title of the Spine journal article4 is mischievous and misleading. The article implies that members of the AAMM have poorer knowledge about low back pain than doctors with no special interest in back pain. The real facts are that no attempt was made by the authors to specify what training or continuing medical education doctors had received, or whether they were members of the AAMM.
References
- Briggs AM, Buchbinder R. Back pain: a National Health Priority Area in Australia? Med J Aust 2009; 190: 499-502.
- Chehade MJ, Bachorski A. Development of the Australian Core Competencies in Musculoskeletal Basic and Clinical Science project — phase 1. Med J Aust 2008; 189: 162-165. 0_i1091851
- Australian Association of Musculoskeletal Medicine. Diploma courses. http://www.musmed.com/ (accessed Sep 2009).
- Buchbinder R, Staples M, Jolley D. Doctors with a special interest in back pain have poorer knowledge about how to treat back pain. Spine (Phila Pa 1976) 2009; 34: 1218-1226. 0_pgfId-1901663