'All Under One Roof': Health Professional Perspectives on Integrating Musculoskeletal Pain Management in a Proximity-Based Primary Healthcare Model

Musculoskeletal Care. 2026 Dec;24(4):e70286. doi: 10.1002/msc.70286.

ABSTRACT

INTRODUCTION: Musculoskeletal (MSK) pain is a leading contributor to disability and service demand in primary healthcare (PHC), particularly in socioeconomically disadvantaged communities. Contemporary responses increasingly emphasise people-centred, multimodal and non-pharmacological approaches. However, in practice, service integration is often limited to co-location, with insufficient clarity regarding how collaboration and integration are operationalised within private, fee-for-service PHC environments.

METHODS: This qualitative study explored how 22 health professionals working within a large-scale, proximity-based primary healthcare precinct in Australia defined and experienced service integration for MSK pain management. Semi-structured interviews were conducted across two timepoints (2021 and 2023) and analysed using reflexive thematic analysis, informed by implementation and people-centred care principles.

RESULTS: Three interdependent enablers of integration were identified: (1) Relationships, enabled by physical proximity, including shared philosophy and respect for professional roles; (2) Communication, characterised by knowledge exchange, forward momentum and shared processes; and (3) Consumer-centred access, via availability of affordable and needed services. Integration was experienced as a continuum, ranging from parallel multidisciplinary practice to higher-order interdisciplinary collaboration involving shared processes and collective responsibility for consumer outcomes.

CONCLUSION: Within this site-specific context, physical proximity acted as a necessary but insufficient condition for effective integration. Higher levels of interdisciplinary practice emerged only when proximity was combined with shared values, effective communication and coordinated consumer flow. These findings provide a base for how proximity-based primary healthcare environments can operationalise people-centred integration and can inform scalable models of MSK care in private PHC settings.

PMID:42897848 | DOI:10.1002/msc.70286