Berendsen Annette J, Kuiken Annegriet, Benneker Wim H G M, Meyboom-de Jong Betty, Voorn Theo B, Schuling Jan
Department of General Practice, University Medical Centre Groningen, University of Groningen, Ant, Deusinglaan 1, 9713 AV Groningen, The Netherlands.
BMC Health Serv Res. 2009 Aug 8;9:143. doi: 10.1186/1472-6963-9-143.
Communication between general practitioners (GPs) and specialists is important, if we want patients to receive the right type of care at the right moment. Most communication takes place through telephone contact, letters concerning information on patients more recently also by email, and joint postgraduate training. As much research has been aimed at the content of communication between GPs and specialists, we wished to address the procedural aspects of this communication. We addressed the following research question. How do GPs and specialists assess their mutual communication through telephone, letters and postgraduate courses?
A cross-sectional study was conducted among a random sample of 550 GPs and 533 specialists selected from the Netherlands Medical Address Book. The response rate was 47% GPs (n = 259) and 44% specialists (n = 232).
Specialists qualify the GPs' telephone accessibility as poor; while GPs themselves do not. Specialists think poorly of the GPs' referral letter. Merely half of GPs feels their questions are addressed appropriately by the specialist, whereas specialists think this number is considerably higher. According to specialists, GPs often do not follow the advice given by them. GPs rate their compliance much higher. Less than a quarter of GPs feel the specialist's letter arrives on time. Specialists have a different perception of this.Both parties wish to receive feedback from one and other, while in practice they do so very little.
GPs and specialists disagree on several aspects of their communication. This impedes improvements. Both GP's accessibility by phone and time span to the specialist's report could be earmarked as performance indicators. GPs and specialists should discuss amongst themselves how best to compose a format for the referral letter and the specialist's report and how to go about exchanging mutual feedback.
如果我们希望患者在恰当的时候得到正确类型的治疗，全科医生（GP）与专科医生之间的沟通至关重要。大多数沟通通过电话联系进行，关于患者信息的信件近来也通过电子邮件发送，还有联合研究生培训。由于许多研究聚焦于全科医生与专科医生之间沟通的内容，我们希望探讨这种沟通的程序方面。我们提出了以下研究问题。全科医生和专科医生如何通过电话、信件和研究生课程评估他们之间的相互沟通？
对从荷兰医学通讯录中随机抽取的550名全科医生和533名专科医生进行了横断面研究。全科医生的回复率为47%（n = 259），专科医生的回复率为44%（n = 232）。
专科医生认为全科医生的电话可接通性较差；而全科医生自己并不这么认为。专科医生对全科医生的转诊信评价不高。只有一半的全科医生觉得他们的问题能得到专科医生的恰当解答，而专科医生认为这个比例要高得多。据专科医生说，全科医生常常不遵循他们给出的建议。全科医生对自己的依从性评价要高得多。不到四分之一的全科医生觉得专科医生的信件能按时送达。专科医生对此看法不同。双方都希望从对方那里得到反馈，但实际上他们很少这样做。
全科医生和专科医生在沟通的几个方面存在分歧。这阻碍了改进。全科医生的电话可接通性以及收到专科医生报告的时间跨度都可被指定为绩效指标。全科医生和专科医生应该相互讨论如何最好地制定转诊信和专科医生报告的格式，以及如何进行相互反馈的交流。
