Clearfield H R
Division of Gastroenterology and Hepatology, MCP-Hahnemann University, Philadelphia, Pennsylvania 19102, USA.
Am J Gastroenterol. 1999 Jun;94(6):1453-6. doi: 10.1111/j.1572-0241.1999.01125.x.
Effective communication skills and the ability to respond to the needs of referring physicians are critical for the maintenance and enhancement of a referral base. One challenge is to determine the reason for the consultation and to respond to the referring physician's interests. The consultation letter should be formatted effectively and the "turn-around time" should be as brief as possible, perhaps by fax as well as mail. Prioritizing the differential diagnosis and diagnostic studies can be helpful to the referring physician. Strategies should be developed to address procedural referrals you may believe are inappropriate. A decision should be made as to whether the consultant or the primary care physician informs the patient of a serious disease diagnosis. Referral guidelines should be developed to assist primary care physicians to determine when a patient should be referred to the gastroenterologist or other specialist. Receptionists should avoid turning away new patients because of a "full schedule" and must determine if other arrangements can be made. A proper response to "hallway consultations" by referring physicians is important. Consultants should make efforts to increase their visibility in the medical community, either by newsletter or lectures to the medical staff. Every effort should be made to avoid speaking disparagingly about other physicians. Consultant strategies should be taught to house staff and fellows in a formal lecture format, in the outpatient clinics, and on hospital rounds.
有效的沟通技巧以及回应转诊医生需求的能力对于维持和扩大转诊基数至关重要。一个挑战是确定会诊的原因并回应转诊医生的关注点。会诊信应格式规范，“周转时间”应尽可能短，或许可以通过传真和邮寄两种方式。对鉴别诊断和诊断研究进行优先级排序可能对转诊医生有所帮助。应制定策略来处理你认为不恰当的程序性转诊。应决定是由会诊医生还是初级保健医生告知患者严重疾病的诊断结果。应制定转诊指南，以协助初级保健医生确定何时应将患者转诊给胃肠病学家或其他专科医生。接待员不应因“日程已满”而拒绝新患者，必须确定是否可以做出其他安排。对转诊医生的“走廊会诊”做出恰当回应很重要。会诊医生应努力通过时事通讯或向医务人员授课等方式提高自己在医学界的知名度。应尽一切努力避免贬低其他医生。应以正式讲座的形式，在门诊诊所和医院查房时，向住院 staff 和研究员传授会诊医生的策略。
