Referral and reply letters are common means by which doctors exchange infor
mation pertinent to patient care. Twenty-eight semistructured interviews we
re conducted exploring the views of oncologists, referring surgeons and gen
eral practitioners. Twenty-seven categories of information in referral lett
ers 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 r
eceive information regarding the patient's medical status, the involvement
of other doctors, and any special considerations. Referring surgeons and fa
mily 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/backgrou
nd than the recipients would like. Referring surgeons and family doctors wa
nt 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
.