PROBLEMS IN COMMUNICATION BETWEEN GENERAL-PRACTITIONERS AND INTERNAL-MEDICINE CONSULTANTS

Using a postal questionnaire, we studied the types of problems that ge neral practitioners encounter in the communication with internal medic ine consultants, and the consequences that occur as a result of these problems. Possible solutions to these problems were analysed, especial ly the use of electronic mail. The questionnaire was sent to 363 gener al practitioners in two regions in The Netherlands; replies were recei ved from 144 (40%). Of these, 47 (33%) reported a total of 82 communic ation problems with the internist concerning the patient described in the most recent letter received from an internist. The most frequently reported problems were: failure of the internist to report in good ti me when referring the patient back to the general practitioner (15; 10 %); failure of the internist to provide sufficient detail in intermedi ate reports (15; 10%). In 39 of 47 patients in which problems occurred , these problems led to a total of 58 consequences. The most frequentl y reported consequences were irritation caused to the general practiti oner (15; 10%) and irritations caused to the patient (13; 9%). We conc lude that communication problems mainly arise from too late delivery o f information, and a lack of understanding by the internist of the inf ormation needs of the general practitioner. Personal contacts between co-treating physicians and well-established protocols are key elements in providing good cooperation between physicians. Electronic mail may be a good option to assist physicians in maintaining protocol-based c ommunication.