[Improvement of communication between consultants and family practitioners: a controlled trial]

Communication between primary care physician and consultants is essential for continuing patient care. Several studies have noted failures of consultants to provide follow-up information to the referring physician. We studied the referral pattern in a family practice clinic, and tried to increase written communication between consultants and primary care physicians. 306 patients referred to medical consultants during a 6-month period received either a routine referral form with the patient's name, age and reason for consultation, or an experimental referral form with a special area for the consultant to fill out and return to the referring family physician via the patient. The overall referral rate was 6.4%, the most frequently consulted specialists being ophthalmologists (27%), followed by surgeons (26.4%), internists (24.7%), otolaryngologists (10%) and gynecologists (8%). Consultation reports were returned to the referring physician in 55% of the cases. The return rate was significantly higher (62.5%) for the experimental form than the standard form (48%), (p < 0.004, X2 = 15.18). This improvement in response rate was seen for all specialists and for the different types of clinics. The proposed referral form is a simple and inexpensive method of improving communication between family practitioners and specialists, thus ensuring continuity of patient care.