Tutorial: Drafting a Physiotherapy Referral and Return-to-Work Letter in One Session

This tutorial shows you how to use a single AI tool session to produce two documents from one clinical case. The task: you have reviewed a patient at twelve weeks post ACL (anterior cruciate ligament) reconstruction. You need to write a physiotherapy referral updating the rehabilitation plan, and a return-to-work letter for his employer.

Doing both in one session takes around fifteen minutes. Doing them separately from scratch would take longer.

The patient: a 32-year-old primary school teacher, twelve weeks post right ACL reconstruction using a hamstring graft. Good recovery to date. He wants to return to work in the classroom at sixteen weeks. He also coaches an after-school football club and wants to know when he can return to that.

Step 1: Write your clinical notes before opening the tool

Spend two minutes writing your anonymised clinical assessment:

Patient: male teacher, 32, 12 weeks post right ACL reconstruction 
(hamstring graft)
Assessment: walking normally without aids, full extension, 
flexion 130 degrees, no effusion, no instability on clinical testing, 
quad and hamstring strength at approximately 70–75% of contralateral side
Current activity: cycling and pool walking, no running yet
Physiotherapy: attending weekly, progressing well

Physiotherapy plan (weeks 12–24):
- Weeks 12–16: progressive gym-based strengthening, proprioception, 
  begin return-to-running programme
- Weeks 16–20: running progression, agility drills, sports-specific 
  movement patterns
- Weeks 20–24: advanced plyometrics, cutting and change-of-direction 
  training, strength symmetry testing

Goals:
- Return to classroom teaching (standing, light movement): week 16
- Return to non-contact coaching: week 20
- Return to full contact sport: minimum 9 months, subject to 
  strength symmetry and clinical clearance

Restrictions currently:
- No running until physiotherapy clears him (likely within 2 weeks)
- No cutting, pivoting, or contact sport
- Desk work at home now: suitable
- Classroom teaching (light activity, no running): from week 16
- Contact coaching: minimum week 20

Step 2: Open the tool and draft the physiotherapy referral first

Open claude.ai or chat.openai.com. Start a fresh conversation. Set the task:

You are helping an orthopaedic surgeon produce clinical correspondence. 
First, draft a physiotherapy referral letter updating the rehabilitation 
plan at 12 weeks post ACL reconstruction. Use these headings: 
Clinical Update, Rehabilitation Plan, Goals, Red Flags to Report Back.
Do not include specific drug information.

Then provide your clinical notes. The tool will produce the referral letter.

Here is an example of what the referral might look like after the tool drafts it:

Dear Physiotherapist,

Thank you for your continued involvement in the rehabilitation of this patient, now at twelve weeks following right ACL reconstruction using a hamstring graft.

Clinical Update

At review today, the patient is progressing well. He is walking normally without aids and demonstrates full knee extension with flexion to 130 degrees. There is no effusion and clinical testing shows no instability. Quadriceps and hamstring strength is estimated at approximately 70–75% of the contralateral side. He is currently cycling and performing pool-based exercise and has not yet commenced running.

Rehabilitation Plan

Please continue as follows:

• Weeks 12–16: Progressive gym-based strengthening, proprioception and balance training, commence return-to-running programme when strength criteria allow.
• Weeks 16–20: Running progression, agility drills, sports-specific movement patterns.
• Weeks 20–24: Advanced plyometrics, cutting and change-of-direction training, formal strength symmetry assessment.

Goals

• Return to classroom teaching (standing, light movement): week 16 as planned
• Return to non-contact coaching activities: week 20 subject to satisfactory progress
• Return to full contact sport: minimum 9 months, subject to strength symmetry testing and clinical clearance

Red Flags to Report Back

Please contact the orthopaedic team if you note: new knee instability, significant pain with progressing exercise, failure to achieve expected strength milestones, or suspected re-injury.

Step 3: Review the physiotherapy referral

Read it against your clinical assessment. In this example:

• The strength estimate (70–75%) matches your notes
• The phase progression matches your plan
• The goals match your clinical assessment

One adjustment: you want to add that running should not commence until hamstring strength reaches a specific threshold that your physiotherapist knows — you add this note yourself at the end of the goals section, not through the tool.

Step 4: Produce the return-to-work letter in the same session

Do not start a new conversation. In the same chat session, type a follow-up instruction:

Now draft a return-to-work letter from the same orthopaedic surgeon 
to the patient's employer (a primary school). The patient is a teacher 
who wants to return to classroom work at 16 weeks post-surgery.

Use these headings: Current Status, Duties He Can Perform, 
Restrictions, Expected Return to Full Duties.

The letter should tell the employer clearly what he can and cannot 
do. Tone: professional and specific. The employer is not medically 
trained.

The tool will produce the return-to-work letter drawing on the clinical context you have already established in the session. Here is an example:

Dear [School Name],

Re: Return to Work — [Title and subject for school staff]

I am writing to provide an update following the recent clinic review of this patient, who is recovering from right knee surgery performed in [month].

Current Status

He is making good progress and his recovery is on track. He is walking normally, has a good range of movement, and is progressing through a structured rehabilitation programme.

Duties He Can Currently Perform

He is currently fit to perform desk-based work from home, which he has been doing without difficulty.

From Week 16 (Approximately [Date])

He may return to classroom teaching, provided this involves:

• Standing and light movement around the classroom
• No running, jumping, or physical activity on the playground or sports field

Restrictions Until Further Notice

He should not:

• Run or jog
• Perform any physical activity involving cutting, pivoting, or sudden changes of direction
• Participate in or supervise physical education lessons involving active participation

Coaching Duties

He is not yet cleared to return to football coaching duties. This will be reassessed at his next clinic review at approximately 20 weeks post-surgery.

Expected Return to Full Duties

Full return to all duties, including active coaching, is anticipated at approximately five to six months following surgery, subject to satisfactory clinical progress.

If you have any questions, please do not hesitate to contact my office.

Yours sincerely, [Your name, title, and contact details]

Step 5: Review the return-to-work letter

Read it from the employer's perspective — a school administrator who has no medical knowledge. Ask:

• Is it clear what he can do when he returns?
• Is it clear what he cannot do?
• Is the coaching restriction clearly stated?
• Are the dates realistic and conditional on progress?

In this example, the distinction between classroom duties and coaching duties is clear. The restriction on physical education is specific and actionable.

One adjustment: you want to add "subject to medical clearance" after the expected return to full duties. Type:

In the "Expected Return to Full Duties" section, change the 
language to make it conditional on satisfactory progress at 
review, not a fixed date.

The tool will revise that sentence.

Step 6: Add identifying details to both documents

Copy both letters into your clinical system. Add:

• The patient's name and relevant identifiers to both
• The physiotherapy department address to the referral
• The school's name and HR contact to the return-to-work letter
• Your name, title, and contact details
• The dates

What this session produced

In fifteen minutes, you have produced two professional clinical documents that would each have taken fifteen to twenty minutes to write individually. The physiotherapy referral is specific and protocol-matched. The return-to-work letter is clear and usable by a non-medical employer.

The tool compressed the structural and writing work. You provided the clinical content and reviewed the output. Every specific clinical detail — the strength percentages, the phase timings, the restrictions — came from your assessment.

What to try next

Apply the same approach to a joint arthroplasty patient who needs a post-operative physiotherapy referral, a GP letter, and a patient education document. The same session can produce all three from a single set of clinical bullet points. Each document takes a targeted prompt, and each requires your review — but the time savings compound quickly.

Remember: AI is a helpful assistant, not a clinician. You make the call.