Survey of Australian emergency physicians' expectations of general practitioner referrals.

This paper reports the first study of Australian emergency physicians which concentrates on their relationship with general practitioners. A self-administered questionnaire was mailed to every known fellow and senior trainee of the Australasian College of Emergency Medicine working in Victoria, Australia. Good response rates were achieved (97% from fellows, 78% from trainees). Referral letters from general practitioners were always read by 99% of respondents. Telephone calls from general practitioners were found to be desirable for imparting details of social history or other qualitative information and for determining the appropriateness of the referral. The list of patients' current medication and the details of any emergency treatment administered by the general practitioner were almost universally considered essential inclusions in all urgent referral letters. Other items of information were considered to be influenced by the particular patient presentation. The majority of respondents (87%) felt that a written management plan had some influence on the patient's management in their emergency department. Eighty nine per cent of respondents stated that they always or usually responded to general practitioners' communications. The outcome for patients attending emergency departments with referral letters warrants study. If a good referral letter is seen to be of value in terms of more accurate diagnosis, quicker patient processing, less investigations and better responses, then general practitioners will be encouraged to write better letters. The results of this study offer a useful definition of inappropriate referral to the emergency department and it may now be possible to investigate any link between poor referral letters and inappropriate referrals.