OBJECTIVE: To evaluate primary care and specialist physicians' satisfaction
with interphysician communication and to identify the major problems in th
e current referral process.
DESIGN: Surveys were mailed to providers to determine satisfaction with the
referral process; then patient-specific surveys were e-mailed to this grou
p to obtain real-time referral information.
SETTING: Academic tertiary care medical center,
PARTICIPANTS: Attending-level primary care physicians (PCPs) and specialist
s.
MEASUREMENTS AND MAIN RESULTS: The response rate for mail surveys for PCPs
was 57% and for specialists was 51%. In the mail survey, 63% of PCPs and 35
% of specialists were dissatisfied with the current referral process. Respo
ndents felt that major problems with the current referral system were lack,
of timeliness of information and inadequate referral letter content. Infor
mation considered, important by recipient groups was often not included in
letters that were sent, The response rate for the referral specific e-mail
surveys was 56% for PCPs and 53% for specialists. In this e-mail survey, 68
% of specialists reported that they received no information from the PCP pr
ior to specific referral visits, and 38% of these said that this informatio
n would have been helpful. In addition, four weeks after specific referral
visits, 25% of PCPs had still not received any information from specialists
.
CONCLUSIONS: Substantial problems were present in the referral process. The
major issues were physician dissatisfaction, lack of timeliness, and inade
quate content of interphysician communication. Information obtained from th
e general survey and referral-specific survey was congruent. Efforts to imp
rove the referral system could improve both physician satisfaction and qual
ity of patient care.