Referral and Consultation Communication Between Primary Care and Specialist Physicians

Medical subspecialization and technological advances have fragmented patient care across numerous physicians. When primary care physicians (PCPs) and specialists don’t communicate about referrals and consultations, patients suffer.

In a random sampling, 4,720 physicians from the 2008 Health System Change Health Tracking Physician Survey were asked about their communications—from PCP to specialist and from specialist to PCP. Considering responses of “always“ or “most of the time” as positive:

  • PCPs sent notification of a patient’s history and reasons for consultation to specialists 69 percent of the time. Specialists reported receiving such notification from referring physicians 35 percent of the time.
  • Specialists sent consultation results to PCPs 81 percent of the time. PCPs reported receiving that information 62 percent of the time.

The survey found three modifiable practice characteristics that were associated with PCPs and specialist reporting communications regarding referrals and consultations:

  1. Having adequate time to spend with patients during the office visit.
  2. Receipt of quality reports regarding patients with chronic conditions.
  3. Nurse support available for monitoring patients with chronic conditions.

If resources were focused so that PCPs could afford nurse care managers, communication rates between referring PCPs and specialist physicians would improve.