Abstract
Referral and reply letters are common means by which doctors exchange information pertinent to patient care. Twenty-eight semi-structured interviews were conducted exploring the views of oncologists, referring surgeons and general practitioners. Twenty-seven categories of information in referral letters and 32 in reply letters after a consultation were defined. The letters to and from six medical oncologists relating to 20 consecutive new patients were copied, and their content analysed. Oncologists, surgeons and general practitioners Australia wide were surveyed using questionnaires developed on data obtained above. Only four of 27 categories of referral information appear regularly (in > 50%) in referral letters. Oncologists want most to receive information regarding the patient's medical status, the involvement of other doctors, and any special considerations. Referring surgeons and family doctors identified delay in receiving the consultant's reply letter as of greatest concern, and insufficient detail as relatively common problems. Reply letters include more information regarding patient history/background than the recipients would like. Referring surgeons and family doctors want information regarding the proposed treatment, expected outcomes, and any psychosocial concerns, yet these items are often omitted. Consultants and referring doctors need to review, and modify their letter writing practices. © 1999 Cancer Research Campaign
Keywords: letters, referrals, cancer consultation, multidisciplinary care, communication
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Selected References
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- Bado W., Williams C. J. Usefulness of letters from hospitals to general practitioners. Br Med J (Clin Res Ed) 1984 Jun 16;288(6433):1813–1814. doi: 10.1136/bmj.288.6433.1813. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cummins R. O., Smith R. W., Inui T. S. Communication failure in primary care. Failure of consultants to provide follow-up information. JAMA. 1980 Apr 25;243(16):1650–1652. [PubMed] [Google Scholar]
- Epstein R. M. Communication between primary care physicians and consultants. Arch Fam Med. 1995 May;4(5):403–409. doi: 10.1001/archfami.4.5.403. [DOI] [PubMed] [Google Scholar]
- Graham P. H. Improving communication with specialists. The case of an oncology clinic. Med J Aust. 1994 May 16;160(10):625–627. [PubMed] [Google Scholar]
- Hull F. M., Westerman R. F. Referral to medical outpatients department at teaching hospitals in Birmingham and Amsterdam. Br Med J (Clin Res Ed) 1986 Aug 2;293(6542):311–314. doi: 10.1136/bmj.293.6542.311. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kamien M. Writing to referring doctors. Aust N Z J Med. 1995 Oct;25(5):463–464. doi: 10.1111/j.1445-5994.1995.tb01487.x. [DOI] [PubMed] [Google Scholar]
- McPhee S. J., Lo B., Saika G. Y., Meltzer R. How good is communication between primary care physicians and subspecialty consultants? Arch Intern Med. 1984 Jun;144(6):1265–1268. [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]
- Nutting P. A., Franks P., Clancy C. M. Referral and consultation in primary care: do we understand what we're doing? J Fam Pract. 1992 Jul;35(1):21–23. [PubMed] [Google Scholar]
- Tattersall M. H., Griffin A., Dunn S. M., Monaghan H., Scatchard K., Butow P. N. Writing to referring doctors after a new patient consultation. What is wanted and what was contained in letters from one medical oncologist? Aust N Z J Med. 1995 Oct;25(5):479–482. doi: 10.1111/j.1445-5994.1995.tb01491.x. [DOI] [PubMed] [Google Scholar]