Views of doctors on clinical correspondence: questionnaire survey and audit of content of letters

Campbell, Bruce; Vanslembroek, Katalijne; Whitehead, Emma; Wauwer, Caroline Van De; Eifell, Ronald; Wyatt, Michael G.; Campbell, John L.

doi:10.1136/bmj.38058.801968.47

Cited by 32 publications

(32 citation statements)

References 3 publications

(3 reference statements)

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“…These letters facilitate the discussion that GPs have with their patients as all details of a clinic consultation have been clearly outlined in the letters. Clinic letters will become a reference for future clinic appointments as well as evidence of the process of informed consent and a medico-legal record 1112. Clinic letters are particularly useful to patients when they are seen by a clinician in the out of hours setting who do not know their history, as increasingly occurs in current practice 13…”

Section: Discussionmentioning

confidence: 99%

Prospective assessment of patient directed outpatient communication from a patient and general practitioner perspective

Mahadavan

Bird

Chadwick

et al. 2009

Postgraduate Medical Journal

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Section: Discussionmentioning

confidence: 99%

Prospective assessment of patient directed outpatient communication from a patient and general practitioner perspective

Mahadavan

Bird

Chadwick

et al. 2009

Postgraduate Medical Journal

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“…3 Nevertheless the quality of referral letters has been and remains variable. [4][5][6][7] In one survey 38% of consultants stated that they have been provided with inadequate information by general practitioners ''fairly'' or ''very often''. 8 Nevertheless, much of the criticism of general practitioners' referral letters has been from a secondary care perspective; it is not clear how well they communicate when measured by their own standards.…”

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confidence: 99%

Measuring the quality of referral letters about patients with upper gastrointestinal symptoms

Jiwa

Coleman²,

McKinley³

2005

Postgraduate Medical Journal

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Background General practitioners state the reason for referring patients in referral letters. The paucity of information in these letters has been the source of criticism from specialist colleagues. Objective To invite general practitioners to set standards for referral letters to gastroenterologists and to apply these standards to actual referral letters to one specialist gastroenterology unit. Methods A scoring schedule was designed based on the responses to a questionnaire survey of a large sample of all general practitioners in one locality. Altogether 350 consecutive letters to a district general hospital about patients referred for an upper gastrointestinal specialist opinion were subsequently scored using the schedule. Results 102 practitioners responded to the survey. Their responses imply that colleagues assess and record findings on 18 potential features of upper bowel disease. In practice most referral letters address fewer than six features of upper bowel disease. The mean number of positive features of upper gastrointestinal disease reported in each letter was one. Conclusions This study reported a failure to meet “peer defined” standards for the content of referral letters set by colleagues in one locality. Referral letters serve many purposes, however, encouraging full documentation of specific clinical findings may serve to increase the pre-referral assessments performed in practice.

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“…10 The absence of previous investigation results was noted in more than 50% of the referral letters in three separate studies, 3,22,24 patients' medical history was not routinely included in referral information, 13,16,25 and allergies 16,23 and clinical findings 5,17,18,22 were generally poorly recorded. These omissions may be due in part to the fact that there is no real consensus amongst different specialties on the ideal information to be included in a referral letter, beyond an agreement on broad information categories.…”

Section: Discussionmentioning

confidence: 99%

Smoothing the passage of patients from primary care to specialist respiratory opinion

O'Byrne

Darlow

Roberts

et al. 2010

Primary Care Respiratory Journal

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Aims: To assess whether information in general practitioner (GP) referral letters provides a basis for selection of diagnostic tests in patients referred for specialist respiratory advice. Methods:We undertook a prospective study within a respiratory outpatients department to compare the diagnostic tests planned at three stages of the referral/specialist consultation process: i) using the GP referral letter alone; ii) using the referral letter and patient history; iii) using the referral letter, patient history, and clinical examination.Results: Analysis of the content of GP referral letters revealed wide variations in referral information. A high proportion of tests selected using the referral letter alone were altered after specialist history-taking and examination. Far fewer changes were recorded between history-taking and examination.Conclusions: Neither literature review nor our study support a system which bases diagnostic test selection on GP referral letters alone. However, our findings suggest that approaches which include specialist history-taking in advance of face-to-face consultation merit further investigation.

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Views of doctors on clinical correspondence: questionnaire survey and audit of content of letters

Cited by 32 publications

References 3 publications

Prospective assessment of patient directed outpatient communication from a patient and general practitioner perspective

Prospective assessment of patient directed outpatient communication from a patient and general practitioner perspective

Measuring the quality of referral letters about patients with upper gastrointestinal symptoms

Smoothing the passage of patients from primary care to specialist respiratory opinion

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