Physician Referrals: Communication is the Key

Written by on April 1, 2015 in Features - No comments

Once upon a time there was a family practice and a surgical practice side by side, even sharing the same parking lot. What a wonderful opportunity to better serve their patients.   The surgical practice administrator had visited the family practice group, welcoming them to the neighborhood and had introduced the referral coordinators. They scheduled a meeting with a desire to better understand what each needed when referring patients. The surgical practice asked how the physicians would like to be kept informed. The family practice physicians said, “a phone call, chat in the parking lot or a letter works for us. Whatever works best for you.”

DocNurseWEBThe surgical practice administrator and employees were very understanding about work-ins and when at all possible, would offer same day appointments. Patients very much appreciated this, conveniently walking over from right next door. To the patient, the family practice physician appeared to be “Super-Doc,” having extra-ordinary powers in requesting that the neighboring surgeon address their surgical needs so quickly. It was a win-win for both practices.

Occasionally, a patient would have to be sent directly to the hospital for urgent surgery. They were able to bypass the emergency department. This made the family practice physician, the surgeon, the patient and patient’s family members very happy.

Then one day a patient who had previously been referred by the family practice physician to the surgeon had returned to see his family physician for flu-like symptoms.  While there, the family physician said, “I see in my notes that I had referred you to a surgeon about possible gallstones, did you see anyone?” the patient confirmed stating, “Yes sir, I had surgery months ago. I have the scar to prove it.  I really liked that surgeon.” The patient pulled up his shirt and low and behold, he was right! There it was, one of the nicest post gallbladder scars ever seen. How embarrassing this was to the family physician. He liked to be kept informed about his patients.

The family practice physician understood that mistakes happen so he called over next door to inquire.  Copies of physician notes were hand delivered by the staff but one important piece was missing. There was no follow up with the physician, informing him of what the surgeon had found.

This was quickly brought to the practice administrator’s attention. When she brought it to the surgeon’s attention, he said, “they should know by now that we are going to take care of their patients. There is no need for all that back and forth. If that’s a problem, then they don’t have to send me anyone else.” And they didn’t.

The moral to the story is without effective, timely communication between physicians, both the quality of care and the patient experience can suffer. Physicians who reported a lack of timely communication regarding referrals had less confidence in their ability to provide high-quality care than colleagues who received timely communication. Primary care physicians know that if they don’t get information about referrals back from specialists, particularly for patients with complex conditions, it impacts the quality of the health care they provide. Gaps in communication may lead to patient harm, delays in care, continuation of incorrect treatment, prolonged length of stay, and increased costs. Lack of direct communication between physicians leads to delays in patients receiving the assessment and treatment they need.

In order for the patient, family members, physicians, surgeons and staff to live “happily ever after” it takes 100% from all players. When one person drops the magic wand, the entire referral process looses all its miraculous powers.

Communication is the essential key. Make it a priority to understand what each practice and each player needs to better serve your patients.

By Denise Price Thomas



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