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In his account of the RSM's excellent conference (February 2002 JRSM1) Malcolm Morrison rightly indicates that no formal conclusions were reached nor were any resolutions passed. My chief disappointment in the meeting was the under-representation of medical educators.
I entirely agree that more cases of back pain should be dealt with in primary care (or in the workplace). There is a mass of evidence on the efficacy and safety of musculoskeletal therapies2. But I cannot accept that it is ‘... the responsibility of all those who deal with back pain, across the disciplines, to ensure that patients do not endure prolonged suffering...’; at present they cannot help it— the great majority of them do not know how!
Professor Mansell Aylward made some pertinent comments on the costs. The most important factor in improving the patient's lot is surely for those in primary care to be taught how to deal with these disorders. Contrary to some long held beliefs3, this is not time-consuming and diminishes the primary-care clinical work-load by reducing the need for multiple follow-up attendances.