Tuesday, January 25, 2011

What Did You Say?

The secret's out: primary care physicians (or PCPs such as myself when I wear my family physician hat) don't communicate very well w/our specialist colleagues (such as myself when I wear my geriatrician hat) about you, our patient.  Incredible, isn't it?!?!  Maybe not when you recall our stereotypically atrocious handwriting.
I mention this because a survey published last week of 4,720 physicians working at least 20 hours/week reported that only 69.3% of PCPs "always" or "most of the time" sent the appropriate paperwork to the specialist to whom they were referring.  Worst, it arrived only 34.8% of the time as reported by the specialists. 

Well, this is kind of like the pot calling the kettle black since only 80.6% of specialists "always" or "most of the time" sent their consultation results back to the referring PCP while only 62.2% of PCPs reported receiving said consult notes.

Have you ever been to a specialist who then asked you "Why are you here?" and really meant it?  And then returned to see your PCP who asked "What did s/he say?"  Isn't this lack of communication appalling?  And I thought we grew out of this after passing through adolescence!

Let's hope that technology in the form of electronic health records will improve the back & forth flow of information (as suggested in an accompanying editorial).  The study also recommends "adequate" visit time (don't hold your breath!) and nurse support for monitoring patients with chronic diseases.  In the meantime, be proactive and check w/each physician's office a day or so prior to your arrival to be sure they've already received the necessary paperwork.  Should that be your responsibility as a patient?  Probably not.  But in this day & age, we need to work together to improve the care we provide & you receive.

Disclosure:  I'm scheduled to give a presentation entitled "The EHR Challenge: How to Choose the Best Fit" this coming Thursday at our Nevada Academy of Family Physicians' 43rd Annual Winter Conference here in lovely South Lake Tahoe where the weather has been sunny and the skiing awesome.