To Family Physicians
Consultation letters are written, only to be sent into a “void” with little or no communication until the patient is actually seen.
More and more frequently specialists are requesting a specific form for their clinic and family physicians can’t keep up with the forms. With the multiplicity of forms, and increasing computerization of physician offices, EMRs are not able to generate information in the format of the specific form being requested.
Trying to call a specialist for advice while awaiting a referral often leads to inefficient “telephone tag” and may get lost in a busy practice environment.
Once seen, the information received back from the specialist may be incomplete and does not provide direction in terms of “who is doing what”.
For more information on why increasing access to medical specialists is important to family physicians, pleas refer the following report: Fact Finding: Increasing Access to Medical Specialists
To Medical Specialists
Advocating for their patients, family physicians make duplicate referrals hoping that someone will see their patient quickly, but then once seen the duplicated referrals are frequently not cancelled.
Family physicians and specialists no longer know each other, and specialists are not comfortable providing advice for someone they have not seen while family physicians are not comfortable phoning a specialist they do not know for advice. Even when phone calls are made, “telephone tag” is often the result.
Necessary investigations and initial management strategies that could have been implemented are not done while waiting for the referral, leading to delays in patient management.
Specialists are frustrated by the perceived lack of information received, leading to less than ideal consultations and often repeated visits for the patient, which is time-consuming and inefficient for the specialist.
Lack of communication and coordination between multiple specialists providing care for individuals with chronic disease.
To Staff
Staff in offices and clinics both have challenges:
From the family physician office much time is spent on the phone trying to figure out how to navigate the system – determining what specialist to refer the patient to and sorting through the endless number of forms the family physician is required to fill out.
From the specialist office much time is spent on the phone trying to get additional information or simply in re-ordering tests as results are difficult to find.
To Patients
Frustration with uncertainty and waits
Requirement to see more than one specialist if the first referral was to the “wrong” specialist