Abstract
BACKGROUND: The professional relationship between general practitioners (GPs) and hospital consultants (sometimes referred to as 'specialists') is important in a health care system based upon the generalist as the first point of contact for patients and the gatekeeper for hospital services. This relationship has been the subject of considerable interest over the years, but little empirical research has been carried out. AIM: To investigate the professional relationship in terms of the balance between cooperation and conflict between GPs and specialists in clinical contact. METHOD: A qualitative study using 24 semistructured interviews and four focus group interviews with a purposeful sample of clinicians working in the south-west of England. A content analysis of the data was performed. RESULTS: There is a high level of mutual respect and cooperation between the two branches of the profession and a strong desire to build a personal relationship over a long period of time. There are few areas of significant disagreement; indeed, most members of both branches of the profession try hard to deal with, or avoid, potential conflict. CONCLUSION: The professional relationship between GPs and specialists is better than the literature and anecdotal stories might suggest.
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Selected References
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- Grace J. F., Armstrong D. Referral to hospital: perceptions of patients, general practitioners and consultants about necessity and suitability of referral. Fam Pract. 1987 Sep;4(3):170–175. doi: 10.1093/fampra/4.3.170. [DOI] [PubMed] [Google Scholar]
- Harding J. Study of discharge communications from hospital doctors to an inner London general practice. J R Coll Gen Pract. 1987 Nov;37(304):494–495. [PMC free article] [PubMed] [Google Scholar]
- Higgins P. M. The GP/hospital interface. J R Coll Physicians Lond. 1979 Jul;13(3):132–138. [PMC free article] [PubMed] [Google Scholar]
- Horder J. P. Physicians and family doctors: a new relationship. J R Coll Gen Pract. 1977 Jul;27(180):391–397. [PMC free article] [PubMed] [Google Scholar]
- Marshall M. N. Sampling for qualitative research. Fam Pract. 1996 Dec;13(6):522–525. doi: 10.1093/fampra/13.6.522. [DOI] [PubMed] [Google Scholar]
- Marshall M. N. The key informant technique. Fam Pract. 1996 Feb;13(1):92–97. doi: 10.1093/fampra/13.1.92. [DOI] [PubMed] [Google Scholar]
- Newton J., Eccles M., Hutchinson A. Communication between general practitioners and consultants: what should their letters contain? BMJ. 1992 Mar 28;304(6830):821–824. doi: 10.1136/bmj.304.6830.821. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Newton J., Hutchinson A., Hayes V., McColl E., Mackee I., Holland C. Do clinicians tell each other enough? An analysis of referral communications in two specialties. Fam Pract. 1994 Mar;11(1):15–20. doi: 10.1093/fampra/11.1.15. [DOI] [PubMed] [Google Scholar]
- Penney T. M. Delayed communication between hospitals and general practitioners: where does the problem lie? BMJ. 1988 Jul 2;297(6640):28–29. doi: 10.1136/bmj.297.6640.28-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pullen I. M., Yellowless A. J. Is communication improving between general practitioners and psychiatrists? Br Med J (Clin Res Ed) 1985 Jan 5;290(6461):31–33. doi: 10.1136/bmj.290.6461.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rawal J., Barnett P., Lloyd B. W. Use of structured letters to improve communication between hospital doctors and general practitioners. BMJ. 1993 Oct 23;307(6911):1044–1044. doi: 10.1136/bmj.307.6911.1044. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roland M. O., Porter R. W., Matthews J. G., Redden J. F., Simonds G. W., Bewley B. Improving care: a study of orthopaedic outpatient referrals. BMJ. 1991 May 11;302(6785):1124–1128. doi: 10.1136/bmj.302.6785.1124. [DOI] [PMC free article] [PubMed] [Google Scholar]
- SUSSER M. W. Further thoughts on the future of medical practice outside the hospital. Lancet. 1963 Feb 9;1(7276):315–315. doi: 10.1016/s0140-6736(63)92253-0. [DOI] [PubMed] [Google Scholar]
- Westerman R. F., Hull F. M., Bezemer P. D., Gort G. A study of communication between general practitioners and specialists. Br J Gen Pract. 1990 Nov;40(340):445–449. [PMC free article] [PubMed] [Google Scholar]
- Whitfield M. J., Bradley M. C. GPs and consultants: is there agreement on patient management? Bristol Med Chir J. 1989 Aug;104(3):75–78. [PMC free article] [PubMed] [Google Scholar]
- Whitfield M. J. What do consultants think of general practice? J R Coll Gen Pract. 1980 Apr;30(213):228–229. [PMC free article] [PubMed] [Google Scholar]
- Wood M. L. Communication between cancer specialists and family doctors. Can Fam Physician. 1993 Jan;39:49–57. [PMC free article] [PubMed] [Google Scholar]