Dictating clinic letters in front of the patient

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7091.1416a (Published 10 May 1997) Cite this as: BMJ 1997;314:1416

Letting patients see copy of consultant's letter is being studied in trial

  1. William Hamilton, General practitionera,
  2. Alison Round, Senior registrar in public health medicineb,
  3. Phil Taylor, General practitionerc
  1. a 12 Barnfield Hill, Exeter EX1 1SR
  2. b Dean Clarke House, Exeter EX1 1RB
  3. c Axminster, Devon EX13 5AQ
  4. d Arthur's Hill Clinic, Newcastle upon Tyne NE4 6BT
  5. e North West London Mental Health Trust, London NW8 0EH
  6. f Maudsley Hospital, London SE5 8AZ

    Editor—B W Lloyd shows that patients approve of a consultant's dictating clinic letters in front of them, but Mike Pringle asks for more evidence to support the idea.1 Our study, funded by Devon Family Health Services Authority, may give this evidence.

    During 1994, consecutive referrals from two general practitioners were randomised to (a) dictation in their presence or immediately after they left the room and (b) whether they were sent a copy of their referral letter. Terminations of pregnancy were excluded. All patients were sent a questionnaire. We monitored attendances at hospital.

    Altogether 171 patients entered the study. The randomisation was to a Latin square design. Thus, of the 137 (80%) patients who responded to the questionnaire, 65 had had dictation in their presence and 72 had not; and 70 had received a copy of the letter and 67 had not. Forty patients received both dictation and a copy of the letter. Fifty three patients rated dictation in their presence very helpful, nine moderately helpful, and two not very helpful; one patient made no answer. Fifty three patients rated receipt of a copy letter very helpful, 12 moderately helpful, and five not very helpful. Eighty one respondents stated that the referral process had increased their understanding of their condition. This was unrelated to dictation in their presence …

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