Outreach clinics in Israel: a common but unregulated phenomenon

Background. Specialist outreach consultations in the primary care setting h ave long been controversial with regard to both their effectiveness in trea ting patients and their potential in improving the interaction between fami ly physicians and specialists. Objective. The aim of this study was to establish the prevalence and nature of outreach consulations in primary care clinics in Israel. Methods. Questionnaires were sent to the heads of all public family practic es of the General Sick Fund in our district (38 practices with about 180 00 0 patients). All 38 practice managers returned completed questionnaires. Results. Twenty-eight of the 38 practices (74%) have some type of specialis t consultation available within their clinics. The most common specialties providing outreach clinics are cardiology (47%), nephrology (45%) and inter nal medicine (39%), where the consultation was performed with the family ph ysician and the patient present. Psychiatry consultations (42%), however, w ere generally performed without the patient being present. Most of the prac tice heads felt that in essence outreach clinics could be a positive way of treating their patients. Conclusions. Head physicians of primary care clinics tend to see outreach c linics as being a very positive tool with which to treat patients. Although many family physicians have some form of specialist consultation available , it is provided and performed mainly on an ad hoc basis. At present no dat a are available on how best to structure these consultations, or on which s pecialties outreach clinics are most suitable.