BMJ  1992;304:821-824 (28 March), doi:10.1136/bmj.304.6830.821

Communication between general practitioners and consultants: what should their letters contain?

Centre for Health Services Research, University of Newcastle upon Tyne.

OBJECTIVE--To canvass the views of all general practitioners and consultants working in Newcastle upon Tyne on the content of referral letters and replies, the feasibility of standardising certain aspects of referral letters, and the use of communications data for audit purposes. DESIGN--A postal questionnaire was sent to all general practitioners and consultants in Newcastle upon Tyne in May 1991. Questions were asked about the clinical and administrative content of letters, the utility of standard categories to state the reason for referral, the idea of using letters for feedback purposes, and communications as a potential topic for professionally led audit. SETTING--Area served by Newcastle upon Tyne Family Health Services Authority and District Health Authority. RESULTS--Replies were received from 274 (77%) doctors (115 general practitioners and 159 consultants). A majority (225; 82%) were in favour of items defined as "always important" forming a minimum requirement for referral letters and for consultants' replies. Using standardised categories to state the reason for referral was not endorsed: 102 (89%) general practitioners and 132 (83%) consultants preferred referrers to use their own words. Using referral communications to provide feedback was less popular with consultants (54; 34%) than general practitioners (72; 63%). Finally, a majority of doctors (179; 65%) were in favour of using written communications as a topic for professionally led audit. CONCLUSIONS--A high degree of consensus exists among clinicians about the content of referral communications. Although doctors may still reject the concept of standardised communications, they have unambiguously endorsed a standard for communication that they can aspire to, and they are prepared to use it as a yardstick for their actual performance.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Article

Communication between GPs and consultants.

N. Zoltie and F. T. De Dombal
BMJ 1992 304: 1181-1182. [PDF]

This article has been cited by other articles:

• Hunter, J. J., Rockman, P., Gingrich, N., Silveira, J., Salach, L. (2008). A Novel Network for Mentoring Family Physicians on Mental Health Issues Using E-mail. Acad. Psychiatry 32: 510-514 [Abstract] [Full text]  
• Jefford, M., Baravelli, C., Dudgeon, P., Dabscheck, A., Evans, M., Moloney, M., Schofield, P. (2008). Tailored Chemotherapy Information Faxed to General Practitioners Improves Confidence in Managing Adverse Effects and Satisfaction With Shared Care: Results From a Randomized Controlled Trial. JCO 26: 2272-2277 [Abstract] [Full text]  
• Schryer, C. F., Gladkova, O., Spafford, M. M., Lingard, L. (2007). Co-management in healthcare: negotiating professional boundaries. DISCOURSE & COMMUNICATION 1: 452-479 [Abstract]  
• Kripalani, S., LeFevre, F., Phillips, C. O., Williams, M. V., Basaviah, P., Baker, D. W. (2007). Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care Physicians: Implications for Patient Safety and Continuity of Care. JAMA 297: 831-841 [Abstract] [Full text]  
• Stille, C. J., Jerant, A., Bell, D., Meltzer, D., Elmore, J. G. (2005). Coordinating Care across Diseases, Settings, and Clinicians: A Key Role for the Generalist in Practice. ANN INTERN MED 142: 700-708 [Abstract] [Full text]  
• Barton, L. L., Ellis, S. C., Berger, M. A. (2003). Pediatric Subspecialty Consultation in a University Hospital: A Reappraisal. CLIN PEDIATR 42: 277-280  
• van Walraven, C., Rokosh, E. (1999). What Is Necessary for High-Quality Discharge Summaries?. American Journal of Medical Quality 14: 160-169 [Abstract]  
• Allan, A.N. (1997). Effective communication from general practice: the referral letter. Health Informatics Journal 3: 37-40 [Abstract]  
• Epstein, R. M. (1995). Communication Between Primary Care Physicians and Consultants. Arch Fam Med 4: 403-409 [Abstract]  
• Elson, R. B., Splett, P. L., Bostick, R. M., Aeppli, D., Haberman, M. (1994). Dietitian Practices for Adult Outpatients With Hypercholesterolemia Referred by Physicians: The Minnesota Dietitian Survey. Arch Fam Med 3: 1073-1080 [Abstract]  

Online poll

Find out more here>> and here>>