treatments, I always refer to orthopedics.

For most persistent M/S pain, I refer for physical therapy. If my clinical judgement leads me to believe PT would be ineffective, I refer directly to ortho. Sometimes a patient will request an ortho referral right out of the gate. Often, I comply with the request, but I tell the patient that the first thing an orthopedist is likely to do is refer for physical therapy. I'm so grateful for the clinical rotations I took in school. It gave me a good sense for what a specialty-care provider is and is not likely to do.