The beneficial relationship of the colocation of orthopedics and physical therapy in a deployed setting: Operation Iraqi Freedom.

In a deployment setting, orthopedic and musculoskeletal injuries represent the majority of both combat-related and noncombat-related injuries. To expeditiously and efficiently manage the large influx of patients, our experience revealed the tremendous benefits of having physical therapy colocated with an orthopedic surgeon in a level III combat support hospital. A physical therapist, working in a physician extender role, can treat the majority of nonsurgical orthopedic patients, thus allowing the orthopedic surgeon to focus his or her skills and time on surgical interventions. This physician extender role, although often overlooked during peacetime, becomes essential during wartime, when critically injured patients are abundant and physicians are in short supply. The lessons learned support the continued colocation of physical therapy and orthopedics in a deployment setting and recognize the need to have more physical therapists placed at level I and II echelons of care.