The Specialist Scope came into existence ten years ago this month. To mark the anniversary, we talked with the first Specialist registered under the scope, Dr Mark Laslett.
Mark is a Musculoskeletal specialist who focuses predominantly on spinal issues. He’s been a registered Physiotherapist since the early 1970s and a Specialist since 2014. We asked him what drew him to become a specialist.
“It was pretty simple really, I’d been practising as a clinical specialist since the 1980s, but it wasn’t recognised or funded any differently from basic treatments.
“Because you’re not paid for that, you can’t be a full-time clinician specialist because the patients you see are always more difficult and take longer, so you have to have a vibrant business model in traditional basic scope of Physiotherapy in order to be able to fund the twenty percent of your patients that require specialist treatment.
“By 1991 I was seeing so many complex patients that myself and my colleague decided to set up a spine care clinic in Manukau Road in Auckland.
“We didn’t call it a ‘physiotherapist specialist clinic’ we called it The Spine Care Clinic where we only saw spinal pain patients and had a different fee structure so we could actually afford to see these patients.”
For Mark, being able to register as a Specialist in 2014 was the first step toward pushing ACC to recognise and fund specialist physiotherapy treatment adequately.
“When I got a specialty status from the Board I immediately went to the ACC and said,
‘“Back in 2006 you said, ‘the Board doesn’t recognise you as a specialist, why should we?’
“I said ‘now they do recognize me so how about it?’ They said ‘no’.”
That changed in 2019 when, after a process started in 2015 by Mark and the only other registered specialist at the time Dr Angela Cadogan, ACC agreed to fund more their assessments & treatments.
“My experience as a specialist has only really been in the full sense since 2019,” Mark says, “it’s really only once you get paid for it that you can viably see the difficult cases economically.”
And it is these difficult and complex cases that have driven Mark throughout his career.
“By the time I’d reached my mid-30s I knew I could satisfactorily and comfortably deal efficiently with eighty percent of all our back pain patients that walked in my door.
“It was the twenty percent, the ones I couldn’t help, that drove me to do more.”
Mark has been a trailblazer for specialist care, and with the issues of scope and funding resolved there has been a surge in Specialist registrations in the last three years.
For practitioners thinking of specialising, Mark has some advice “If you want to see the more difficult patients, if you are fascinated by the cases that fail regular physiotherapy treatments and the treatments of other clinicians, if you’re prepared to take on that burden – and it is a burden – then specialty is for you.
“Specialisation acknowledges extra expertise and appropriate funding allows you the time needed to get successful outcomes.”