Interpractitioner Communication: Telephone Consultations Between Rural General Practitioners and Specialists

Hollins, Jane; Veitch, Craig; Hays, Richard

doi:10.1111/j.1440-1584.2000.tb00361.x

Cited by 6 publications

(7 citation statements)

References 10 publications

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“…Even though follow‐up care is to be de‐adopted and not to be substituted by GPs, a lack of trust in GPs by both dermatologists and patients plays an important role, as the GP will be the first healthcare provider of contact for the patient after being discharged. Trust has been found to be an important factor, not only between patients and physicians, but also between GPs and specialists, as higher trustworthiness improves the communication between physicians . Improving GPs’ education in skin cancer may increase the level of trust between physicians, and that of patients, and may therefore reduce the perceived need to keep patients under dermatological follow‐up .…”

Section: Discussionmentioning

confidence: 99%

Factors influencing current low‐value follow‐up care after basal cell carcinoma and suggested strategies for de‐adoption: a qualitative study

Egmond

Wakkee

Rengen³

et al. 2019

Br J Dermatol

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SummaryBackgroundProviding follow‐up to patients with low‐risk basal cell carcinoma (BCC) can be considered as low‐value care. However, dermatologists still provide substantial follow‐up care to this patient group, for reasons not well understood.ObjectivesTo identify factors influencing current BCC follow‐up practices among dermatologists and suggested strategies to de‐adopt this low‐value care. In addition, views of patients regarding follow‐up care were explored.MethodsA qualitative study was conducted consisting of 18 semistructured interviews with dermatologists and three focus groups with a total of 17 patients with low‐risk BCC who had received dermatological care. The interviews focused on current follow‐up practices, influencing factors and suggested strategies to de‐adopt the follow‐up care. The focus groups discussed preferred follow‐up schedules and providers, as well as the content of follow‐up. All (group) interviews were transcribed verbatim and analysed by two researchers using ATLAS.ti software.ResultsFactors influencing current follow‐up care practices among dermatologists included complying with patients’ preferences, lack of trust in general practitioners (GPs), financial incentives and force of habit. Patients reported varying needs regarding periodic follow‐up visits, preferred to be seen by a dermatologist and indicated a need for improved information provision. Suggested strategies by dermatologists to de‐adopt the low‐value care encompassed educating patients with improved information, educating GPs to increase trust of dermatologists, realizing appropriate financial reimbursement and informing dermatologists about the low value of care.ConclusionsA mixture of factors appear to contribute to current follow‐up practices after low‐risk BCC. In order to de‐adopt this low‐value care, strategies should be aimed at dermatologists and GPs, and also patients.

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Section: Discussionmentioning

confidence: 99%

Factors influencing current low‐value follow‐up care after basal cell carcinoma and suggested strategies for de‐adoption: a qualitative study

Egmond

Wakkee

Rengen³

et al. 2019

Br J Dermatol

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“…The narrative of the patient's symptoms from one clinician to another plays a decisive role for using medevacs or not, as does the trust placed in one provider to accurately describe the situation to another. It is important to note the influence a nurse has on medevacs when framing the narration of the patient's symptoms [35].…”

Section: Medical Decision-makingmentioning

confidence: 99%

Non-clinical determinants of Medevacs in Nunavut: perspectives from northern health service providers and decision-makers

McDonnell

Lavoie

Healy

et al. 2019

International Journal of Circumpolar Health

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A medevac involves the transport of a critically ill patient, usually by plane or helicopter, to access necessary and at times life-saving care, most often only accessible in urban centres. Medevacs are commonly used in resource-limited and geographically isolated areas in Canada.The objective of this study was to explore the determinants of medevac decision-making from the perspective of frontline care providers and decision-makers in Nunavut. For this purpose, we conducted a secondary analysis of 90 in-depth interviews.Findings indicate that medevacs can be the result of a number of intersecting factors, including the referring and receiving provider’s experience, insufficient staffing in health centres, lack of access to diagnostic or treatment-related, and challenges related to recruitment and retention. An expanded scope of practice for frontline care providers, and a related lack of training and/or confidence in skills, only add to these challenges.Medevacs play an important role related to managing shifting community nursing workloads, which expands and contracts in response to local needs. Attention to structural issues, putting in place virtual peer support systems, resolving vacancies left by the lag between attrition and recruitment, increasing access to training, and local diagnostic and treatment equipment, might decrease reliance of medevacs.

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“…Recently, there have been attempts to introduce innovative communication methods at the primary and secondary care interface, specifically in Australia, Honduras, Nepal, and the United States of America (17)(18)(19)(20)(21)(22)(23)(24). However, communication between primary and secondary care levels, particularly in Latin America, is in the form of written referrals and written replies.…”

Section: Referral Systemsmentioning

confidence: 99%

Reply letter utilization by secondary level specialists in a municipality in Brazil: a qualitative study

Harris

Ferreira²,

Morães³

et al. 2007

Rev Panam Salud Publica

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Despite a general understanding of its importance, specialists in Camaragibe had difficulty adopting the reply letter as a form of communication at the interface between primary and secondary care levels. The reply letter can be effective in improving communication at the interface, but the broad cultural, historical, and organizational features of secondary level specialists need to be considered in order to improve reply letter utilization.

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Interpractitioner Communication: Telephone Consultations Between Rural General Practitioners and Specialists

Cited by 6 publications

References 10 publications

Factors influencing current low‐value follow‐up care after basal cell carcinoma and suggested strategies for de‐adoption: a qualitative study

Factors influencing current low‐value follow‐up care after basal cell carcinoma and suggested strategies for de‐adoption: a qualitative study

Non-clinical determinants of Medevacs in Nunavut: perspectives from northern health service providers and decision-makers

Reply letter utilization by secondary level specialists in a municipality in Brazil: a qualitative study

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