A friend’s 85-year-old mother had surgery requiring two different types of cardiologists. Besides the primary care physician (PCP), her parent was seeing the two heart physicians and two additional specialists for other reasons. When my friend, on a visit to the primary care physician with her mom, asked a question about dizziness and the possibility that one of the cardiologist’s medications was interacting with one of the primary care doctor’s medications, confusion arose because a report from the specialist’s care and prescriptions had not yet been sent to the PCP’s office. No communication occurred between the specialist and the primary care doctor.
Recently a January 10, 2011 article in the Archives of Internal Medicine, Referral and Consultation Communication Between Primary Care and Specialist Physicians (abstract), described a study that addresses the effectiveness of communication between physicians. The article is not freely available. The objective of the research was to examine “… PCP’s and specialists’perceptions of communication regarding referrals and consultations” because interaction appears to be inconsistent. Moreover, the researchers surmised that better communication can lower, at least somewhat, medical care costs.
Data was collected using information from the 2008 Health System Change Health Tracking Physician Survey which randomly surveyed 4,720 physicians and had a response rate of 61.9%. Factors that had a positive association with communication included:
- Doctors reporting that they had adequate time to spend with patients.
- Practices including a nurse to help patients with chronic condition.
- Specialists making use of health information technology.
- Physicians practicing in integrated or group practices.
Interestingly, how a physician was paid, Medicare, Medicaid, fixed salary, hourly, or share of practice revenue, had little or no association with strong communication.
In the January 31, 2011 Boston Globe, physician Madeliene Biondolillo, described how her 84-year-old mother almost died after a heart attack when doctors did not communicate with one another, and most importantly, with her mother’s primary care physician. She writes:
If the hospital doctors had spoken to her primary care physician, they could have had all the information they needed to guide their decisions. But hospital doctors often don’t communicate with office doctors, leaving the patient to fend for herself, just when most vulnerable. In addition, office doctors are responsible for a patient’s care after she leaves the hospital, but frequently don’t even know that she’s been hospitalized until she returns to the office.