Study finds dramatic rift in PCP-specialist communication

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Whenever physician blogger Kevin Pho, MD, refers a patient to a specialist, a copy of the patient's recent notes, labs and diagnostic tests is faxed to the specialist, often prior to their visit. And as part of the same seemingly 'standard procedure,' he usually gets a fax from the specialist after the visit describing what happened.

But according to the results of a new survey published in the Archives of Internal Medicine, this basic exchange happens far less often than it should. To emphasize the disconnect even further, PCPs and specialists can't even agree on the severity of their communication problem.

In the survey of 4,720 physicians, for example, 69.3 percent of PCPs reported 'always' or 'most of the time' sending notification of a patient's history and reason for consultation to specialists, but only 34.8 percent of specialists said they 'always' or 'most of the time' received such notification.

Meanwhile, 80.6 percent of specialists said they 'always' or 'most of the time' send consultation results to the referring PCP, but only 62.2 percent of PCPs reported getting such information.

This failure to communicate clearly poses a threat to patient care. Among those surveyed, doctors who reported receiving adequate information from their colleague were also more likely to note 'adequate' time spent with patients, receipt of quality reports regarding patients with chronic conditions and nurse support for monitoring patients with chronic conditions, researchers found.

According to Pho, who was not involved in the study, specialists who still dictate their notes tend to have the longest lag time in communicating with PCPs. "The solution, obviously, is better incorporation of health IT," Pho writes. "I should be able to log into a patient's chart and see both my note and the specialist's note side by side. That's the way it works in the VA, which has a single, unified electronic health record system."

To learn more:
- read the post in the Wall Street Journal Health Blog
- see the post from Kevin Pho, MD
- here's the abstract from the Archives of Internal Medicine

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