Audit of consultant physicians’ reply letters for referrals to clinics in a tertiary teaching hospital

Abstract

Opportunities exist for improving quality of consultant physicians' reply letters in terms of greater use of problem lists, contingency plans, prognostic statements and patient-centred assessments, as well as more frequent enunciation of consultants' reasoning behind requests for further tests and changes to current management. Use of structured letter templates may facilitate more consistent inclusion of key information to referring doctors.

The gaps in specialists' diagnoses

“…While an exhaustive list of specialty‐specific investigations may find no abnormality within a particular organ system, this may not provide diagnostic closure for the patient and may generate frustration and loss of trust in the system of care as a whole. In an audit of 120 specialist reply letters to general practitioners for referrals that involved diagnostic issues, only 69 (57.5%) stated a specific diagnostic formulation 19 …”

“…In an audit of 120 specialist reply letters to general practitioners for referrals that involved diagnostic issues, only 69 (57.5%) stated a specific diagnostic formulation. 19…”

Valued Components of a Consultant Letter from Referring Physicians’ Perspective: a Systematic Literature Synthesis

“…The amount of information contained in the letter was a commonly recurring element, with three articles discussing it. 9,[15][16][17] All four preferred brevity although none addressed this quantitatively. Two mentioned lengths of less than two typewritten pages, 17 or less than 350 words.…”

The CanPain SCI Clinical Practice Guideline for Rehabilitation Management of Neuropathic Pain after Spinal Cord: recommendations for model systems of care

“…They also require that the treating clinician is sensitive to and aware of the patient's needs and concerns, and these are addressed in a timely fashion. Communication ideally should be as rapid as possible; patients are often intolerant of anything but a few days delay, highlighting the importance of rapid (e-mail) communication of specialist reports [Dawn et For primary care physicians, it is important that they receive a prompt, clear, succinct response from the pain specialist on the diagnosis and management as well as justification for the course of action [Scott et al 2004]. In turn, specialists expect the primary care physician to provide sufficient clear information about the problem and an adequate pain history [Piterman & Koritsas 2005a].…”