Views of doctors on clinical correspondence: questionnaire survey and audit of content of letters
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《英国医生杂志》
1 Royal Devon and Exeter Hospital, Exeter EX2 5DW, 2 Department of Surgery, Freeman Hospital, Newcastle upon Tyne NE7 7ON, 3 Peninsula Medical School, Exeter EX2 5DW
Correspondence to: B Campbell bruce.campbell@nice.nhs.uk
Introduction
Questionnaires were sent to 360 general practitioners, 157 in areas served by the Royal Devon and Exeter Hospital and 203 in areas served by the Freeman Hospital, Newcastle, and to the consultants doing outpatient clinics (107 in Exeter and 101 in Newcastle), asking for their views on the desirability (always/usually important or sometimes/never important) of defined items4 in the referral letter and replies. The response rate was 84% for both general practitioners (304/360) and consultants (174/208); the table shows their views. General practitioners now attached greater importance to documenting three items in their letters than in 1992: medical history, findings on investigation, and whether the referral is new. An increased proportion of consultants concurred with the need for medical history, but fewer consultants viewed what the patient expects from the referral as an important item. Fewer general practitioners and consultants thought that the general practitioner's expectation was an important item. A higher proportion of consultants now thought that including a summary of the case history in the consultant's letter was important.
Views on, and contents of, general practitioners' and consultants' referral letters. Values are numbers (percentages) of respondents who viewed each item as "always/usually important" and number (percentage) of letters containing the items
Letters (including attachments) about two recent outpatient referrals from each consultant were audited, using uniform criteria for each item of content (table). The defined items were recorded more often in Exeter than in Newcastle by both general practitioners (six items) and consultants (three items). For two items, general practitioners in Newcastle recorded items more often.
Comment
Jacobs LGH, Pringle MA. Referral letters and replies from orthopaedic departments: opportunities missed. BMJ 1990;301: 470-3.
Rutherford R, Gabriel R. Audit of outpatient letters. BMJ 1991;303: 968.
Grol R, Rooijackers-Lemmers N, van Kaathoven L, Wollersheim H, Mokkink H. Communication at the interface: do better referral letters produce better consultant replies? Br J Gen Pract 2003;53: 217-9.
Newton J, Eccles M, Hutchinson. Communication between general practitioners and consultants: what should their letters contain? BMJ 1992;304: 821-4.
Working Group on Copying Letters to Patients. Copying letters to patients: a report to the Department of Health and draft good practice guidelines for consultation. Leeds: Department of Health, 2002.(Bruce Campbell, consultan)
Correspondence to: B Campbell bruce.campbell@nice.nhs.uk
Introduction
Questionnaires were sent to 360 general practitioners, 157 in areas served by the Royal Devon and Exeter Hospital and 203 in areas served by the Freeman Hospital, Newcastle, and to the consultants doing outpatient clinics (107 in Exeter and 101 in Newcastle), asking for their views on the desirability (always/usually important or sometimes/never important) of defined items4 in the referral letter and replies. The response rate was 84% for both general practitioners (304/360) and consultants (174/208); the table shows their views. General practitioners now attached greater importance to documenting three items in their letters than in 1992: medical history, findings on investigation, and whether the referral is new. An increased proportion of consultants concurred with the need for medical history, but fewer consultants viewed what the patient expects from the referral as an important item. Fewer general practitioners and consultants thought that the general practitioner's expectation was an important item. A higher proportion of consultants now thought that including a summary of the case history in the consultant's letter was important.
Views on, and contents of, general practitioners' and consultants' referral letters. Values are numbers (percentages) of respondents who viewed each item as "always/usually important" and number (percentage) of letters containing the items
Letters (including attachments) about two recent outpatient referrals from each consultant were audited, using uniform criteria for each item of content (table). The defined items were recorded more often in Exeter than in Newcastle by both general practitioners (six items) and consultants (three items). For two items, general practitioners in Newcastle recorded items more often.
Comment
Jacobs LGH, Pringle MA. Referral letters and replies from orthopaedic departments: opportunities missed. BMJ 1990;301: 470-3.
Rutherford R, Gabriel R. Audit of outpatient letters. BMJ 1991;303: 968.
Grol R, Rooijackers-Lemmers N, van Kaathoven L, Wollersheim H, Mokkink H. Communication at the interface: do better referral letters produce better consultant replies? Br J Gen Pract 2003;53: 217-9.
Newton J, Eccles M, Hutchinson. Communication between general practitioners and consultants: what should their letters contain? BMJ 1992;304: 821-4.
Working Group on Copying Letters to Patients. Copying letters to patients: a report to the Department of Health and draft good practice guidelines for consultation. Leeds: Department of Health, 2002.(Bruce Campbell, consultan)