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Fitting disability into practice--focus on spinal cord injury.

BACKGROUND
People with specialised needs such as spinal cord injury (SCI) may not feature prominently in the caseload of the general practitioner. However, when people with chronic disabilities are aggregated, they constitute a reasonable percentage of consultations. It may be difficult to deliver high quality health care for such complex patients.


OBJECTIVE
We propose a method for integration of health care and prevention activities for patients with SCI in general practice, using tools such as a structured questionnaire, general practice management plans and team care arrangements.


DISCUSSION
Practice structures can efficiently and effectively accommodate people with disabilities. Tools can serve as clinical prompts, help with planning, save time, and be financially rewarding. Importantly, they can anchor a 12 month cycle of preventive health care, allowing systematic monitoring and increasing intensity/coordination of professional input for those identified with greatest needs.