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Communication Disconnect Between Primary Care and Specialist Physicians

Archives Study: Two-thirds of Primary Care Physicians Say they Regularly Send Patient Referral Information to Specialists, but only one-third of Specialists Report Receiving Information

News Release
Jan. 10, 2011

FURTHER INFORMATION, CONTACT:
Alwyn Cassil (202) 264-3484 or acassil@hschange.org

WASHINGTON , DC—When it comes to sharing information about patient referrals and consultations, primary care and specialist physicians have decidedly different views about how often their colleagues communicate with them, according to a national study by researchers at the Center for Studying Health System Change (HSC) in the Jan. 10 Archives of Internal Medicine.

For example, 69.3 percent of primary care physicians (PCPs) reported regularly—“always” or “most of the time”—sending a patient’s history and the reason for the referral to the specialist, but only 34.8 percent of specialists said they regularly receive such information, according to the study funded by the Robert Wood Johnson Foundation (RWJF). On the flip side, 80.6 percent of specialists said they regularly send consultation results to the referring PCP, but only 62.2 percent of PCPs said they received such information, the study found.

Physicians who did not receive timely communication regarding referrals and consultations were more likely to report that their ability to provide high-quality care was threatened, the study found.

“The bad news is that there’s a real communication disconnect between primary care and specialist physicians about patient referrals and consultations,” said Ann S. O’Malley, M.D., M.P.H., coauthor of the study with James D. Reschovsky, Ph.D., an HSC senior researcher. “The good news is that the study identified factors that were associated with better communication between primary care and specialist physicians.”

For both PCPs and specialists, having adequate time to spend with patients during an office visit was far and away the most important factor in whether physicians were more likely to report sending and receiving information about patient referrals and consultations, the study found.

Other factors that were associated with improved communication for both PCPs and specialists included practice supports for care management, specifically whether physicians received feedback reports on the quality of care for their patients with chronic conditions and the presence of nurse support for monitoring patients with chronic conditions. The use of health information technology was associated with higher reports of receiving and sending communication by specialists but not by PCPs.

The study, “Referral and Consultation Communication Between Primary Care and Specialist Physicians: Finding Common Ground,” is based on HSC’s 2008 nationally representative Health Tracking Physician Survey, which collected information from 4,720 practicing physicians. The survey, which was funded by RWJF, had a 62 percent response rate.

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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is affiliated with Mathematica Policy Research.

 

 

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