Communications between General Practitioners and Consultants

Long, Andrew; Atkins, Jennan

doi:10.1136/bmj.4.5942.456

Cited by 67 publications

(33 citation statements)

References 4 publications

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“…This study confirms the findings of others that educational interventions are more effective if they are practice based and incorporate audit and the use of opinion leaders. [21][22][23][24] Similarly, GPs dislike lectures 25 and prefer topics that are based upon their daily work, 26,27 a form of problem-based learning. This study incorporated these various educational strategies, which were well received by the participants.…”

Section: Discussionmentioning

confidence: 99%

Why do GPs not implement evidence-based guidelines? A descriptive study

Cranney¹,

Warren²,

Barton³

et al. 2001

Family Practice

174

161

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Objectives. Our aim was to identify what is impeding GPs from pursuing currently recognized good practice and implementing evidence-based guidelines in their management of hypertension in the elderly. Method.We carried out a qualitative study using semi-structured interviews conducted during focus group outreach visits to 34 GPs from nine practices in Merseyside involved in an educational programme designed to improve the management of hypertension in the elderly.Results. Several barriers to the implementation of evidence-based guidelines in the management of hypertension in the elderly were identified. These included: doubts about the applicability of trial data to particular patients; the poor adherence of GPs to practice protocols; ageist attitudes of some GPs; the effect of time pressure and financial considerations making the subject a low priority; the absence of an effective computer system; and the absence of an educational mentor. All participants demonstrated a very positive attitude to practice-based education. They also welcomed external audit data, which compared their performance with that of other practices. Single-handed GPs were particularly enthusiastic about this approach as it provided them with the peer pressure they lacked. Conclusions.In order to bridge the gap between research and practice, educators need to address the various 'barriers to change' amongst practitioners.

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Section: Discussionmentioning

confidence: 99%

Why do GPs not implement evidence-based guidelines? A descriptive study

Cranney¹,

Warren²,

Barton³

et al. 2001

Family Practice

174

161

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show abstract

“…These tasks are not optional extras: they should be priorities in the schedule of every district medical officer. 2 Attendances may vary from month to month according to the season and are often dictated far more by social, geographic, and agricultural factors than purely medical ones. The district medical officer must find and record these idiosyncrasies and interpret the regional statistics against this background, for without this interpretation a misleading picture may be drawn.…”

mentioning

confidence: 99%

Usefulness of letters from hospitals to general practitioners.

Bado¹,

Williams²

1984

BMJ

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“…As has been mentioned, many OPs complain of delays in receiving letters, and sometimes of not receiving them at all. This echoes a concern expressed in many previous studies (Cummins et ai, 1980;de Alarcon et ai, 1960;Fraser et ai, 1974;Isbister, 1980;Long and Atkins, 1974). Such failures in communication put at risk the efficient functioning of the OP-specialist partnership, on which much of hospital medical practice is based.…”

Section: Dliculioamentioning

confidence: 48%

Letters from Psychiatrists to General Practitioners

Margo

1982

Bull. R. Coll. Psychiatr.

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The need for clear communication in medicine is often stressed, but of all aspects of medical communication probably the least attention is given to that between doctors themselves. The structure of the NHS and the mode of referral from general practitioners (0Ps) to specialists mean that the quality of communication between OP and specialist has a strong influence on the way patients are managed and the standard of the care provided. Although it might seem preferable that contact between doctors should be on a face to face basis, this is often not possible. By far the most common mode of communication between OP and specialist is the letter.The most important letter for setting the tone of the partnership involving hospital and 0 P is that sent by the specialist to the 0 P after the first assessment visit. This initial letter is the one which reaches the OP at his most receptive, with the particular problem which led to referral fresh in his mind. At times OPs refer patients as much for their own needs as for those of the patient. If the response to his referral leaves the 0 P feeling his needs are being neither met nor understood, thil can undermine the patient's further care and the OP's attitUde towards him (Brook, 1978).For some medical or surgical conditions a structured, even pro forma letter may be an adequate and relatively economic form of communication (Leading Article, Lancet, 1973). However, such letters are less suitable in psychiatry, where the greater complexity of problems and their multifaceted nature create a need for greater length and less structure.Psychiatrists, however, have to ask themselves at what point greater length and lack of structure in letters might actually impede the communication process; and as time (medical and secretarial) is costly, to what extent long letters are appreciated by OPs and thereby justified. In addition, consideration needs to be given to the aims of the letters.Hospital letters have two main aims. The first, as suggested above, concerns the total care of the patient; the second has to do with the educative value of the letter (Cummins et ai, 1980). This paper reports an attempt to audit letters by a survey of general practitioners in order to ascertain whether detailed letters were appreciated and whether the aims of the communication were being met.ne survey This survey began as an informal attempt to assess the value of letters from a teaching hospital psychiatric team to oPs. Particular stress was placed on the response to the letter sent by the psychiatrist to the OP after the initial outpatient assessment. The study does not offer a comparison of oPs' responses to two or more ditrerent formats of letter, but G Ps were asked to comment freely and were able to make comparisons with letters received from other tc=ams or specialties. MethodGeneral practitioners who had made referrals to the outpatient clinics run by a particular psychiatric team during a four-month period were surveyed by questionnaire between two and four months after the end of the per...

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Communications between General Practitioners and Consultants

Cited by 67 publications

References 4 publications

Why do GPs not implement evidence-based guidelines? A descriptive study

Why do GPs not implement evidence-based guidelines? A descriptive study

Usefulness of letters from hospitals to general practitioners.

Letters from Psychiatrists to General Practitioners

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