Primary care and idiopathic scoliosis: an evaluation of family physicians' roles.

UNLABELLED: Idiopathic scoliosis (IS) can progress silently during growth. Early primary care detection prevents curve progression and reduces treatment burden. This study aimed to assess the role of family physicians in screening, diagnosis, counseling, and follow-up of adolescents with IS, and to evaluate primary care attributes using the Primary Care Assessment Survey (PCAS). This cross-sectional study included 150 patients with IS followed at a university orthopedics clinic in Türkiye. Data were collected via structured telephone interviews using a custom 13-item questionnaire and the validated Turkish PCAS. Descriptive statistics and bivariate parametric and non-parametric tests were used for the analysis (p < 0.05). Only 11% of participants were first diagnosed by family physicians, whereas 68% were diagnosed by orthopedic surgeons. Primary care involvement was low: scoliosis-focused examination (15%), counseling (15%), referral (15%), and exercise recommendations (19%) were infrequent. PCAS scores were highest for longitudinal continuity (79 ± 20) and trust (63 ± 12), and lowest for preventive services and counseling (44 ± 35). Late-onset scoliosis was associated with significantly higher scores in comprehensive knowledge, physical care, personal approach, accessibility, and communication (p < 0.05).

CONCLUSION: Most patients with IS are diagnosed outside primary care, highlighting a substantial underutilization of opportunistic screening and early clinical evaluation in primary care settings. Standardizing scoliosis screening during routine adolescent well-visits, enhancing primary care awareness and guidance, and strengthening referral pathways are crucial for enabling earlier detection, modifying disease progression, and mitigating long-term clinical burdens.

WHAT IS KNOWN: • Early detection of idiopathic scoliosis (IS) through opportunistic screening prevents curve progression, avoids invasive surgeries, and reduces long-term healthcare burdens..

WHAT IS NEW: • Only 11% of IS patients are diagnosed in primary care, revealing critical gaps in screening, posture examination, and counseling despite high longitudinal trust in family physicians..