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Doctors Communicate Poorly Among Themselves, Study Finds

Cheryl Clark, for HealthLeaders Media, January 12, 2011

If accountable care organizations and healthcare reform practices have a chance of improving quality and lowering cost, primary care providers and specialists must share essential information about their patients in a timely way. But that essential communication happens rarely, according to research published in this week's Archives of Internal Medicine.

Worse, specialists and primary care physicians don't even know how much essential communication they're not sharing, because their perceptions of how much timely information is exchanged varies greatly.

Ann O'Malley, MD, and James Reschovsky, of the Center for Studying Health System Change in Washington, D.C. say they believe their study is the "first nationally representative study of physicians to describe interspecialty communication regarding consultations and referrals."

The researchers surveyed 4,720 physicians in both camps who provide at least 20 hours per week of direct patient care. They analyzed responses sent to the Center's 2008 Health Tracking Physician Survey, the fifth in a series since 1996.

For example, questions asked of primary care providers were "When referring a patient to a specialist, how often do you send the specialist notification of the patient's history and the reason for consultation?" and "How often do you receive useful information about your referred patients from specialists?"

Specialists, on the other hand, were asked " When you see a patient referred to you by a PCP, how often do you receive notification of the patient's medical history and reason for consultation?" and "For patients who were referred t you by a PCP, how often do you send the PCP notification of the results of your consultation and advice to the patient?"

Responses could be "always," "most of the time," "sometimes," "seldom or never" and "not applicable."

The way the two groups answered those questions varied "significantly," O'Malley and Reschovsky wrote.

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5 comments on "Doctors Communicate Poorly Among Themselves, Study Finds"


Kathleen Kinser (1/20/2011 at 10:28 AM)
Great points, Beth. There have been many studies about the inefficiencies of reaching physicians, and it is often a problem that physicians have learned to live with over time. So, it's not something that physicians or hospitals readily identify as an acute problem. Although, after looking closer, you can easily find many hospitals with lots of hours wasted trying to reach physicians, consults lost, and patient care adversely affected. My company, PerfectServe, has already solved this problem for nearly 16,000 physicians in hospitals and private practices across the nation so far. Here's the link to a paper on "Connecting with physicians: the hospital problem no one talks about" http://tinyurl.com/32moqlm.

Beth Boynton, RN, MS (1/15/2011 at 4:55 PM)
There is plenty of evidence about poor communication among healthcare professionals as well as its connection to safety, costs, workplace violence and job satisfaction. HCPs need time, training and supportive work cultures to communicate and collaborate effectively. I am interested in opportunities to develop curriculum on interprofessional communication and collaboration in schools for all HCPs and in training leaders in group dynamics, emotional intelligence, authentic leadership and complex adaptive systems. Beth Boynton, RN, MS, author of "Confident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplaces.

Mike Bahn (1/14/2011 at 1:02 PM)
For the past 15.5 years I was a staff attorney for a state's medical board reviewing and assessing physician disciplinary cases. Failure to communicate or ineffective communication between treating providers of patients was a common problem, and frequently part of the sub-par care issues in the complaint cases. Usually this was seen in cases where the complained of doctor was in a solo or small group practice.