Three hundred and fifty-nine consecutive referral letters to Baragwana
th Hospital's gynaecological outpatients' department were analysed. Le
tters from private doctors contained significantly less clinical infor
mation than those from clinics. Only 11% of referring private doctors
mentioned what treatment they had,Given patients before sending them t
o hospital. Soweto clinic nurses tended to include more information in
their letters than clinic doctors. There were no significant differen
ces in the number of appropriate referrals and incorrect diagnoses fro
m private doctors, clinic doctors and clinic nurses respectively. The
poor communication, especially between general practitioners and the h
ospital, is probably the result of overwork and lack of time. Hospital
doctors should reply to well-written referral letters, and liaison be
tween clinics and the hospital ought to be improved and expanded.