Who is checking the quality of referrals? College replies

Issue: BCMJ, Vol. 59, No. 5, June 2017, page(s) 256 Letters
Gerrard A. Vaughan, MD, Heidi M. Oetter, MD

The College would like to thank Dr Holtby for his submission to the BCMJ regarding the quality of information provided by a referring physician on behalf of their patient. While physicians seldom raise this as a formal matter with the College, his views are undoubtedly shared by many in the profession—both consulting and primary-care physicians alike.

The College agrees that in a patient-centred health care system, physicians have a duty to provide clear and comprehensive request-for-consultation letters supplemented by supporting documentation.

Likewise, consultants have a duty to provide a timely response to the referring physician acknowledging the request, as well as a report. The College would go further to say that communication should also be delivered in a timely manner to the patient.

Dr Holtby’s letter is well timed. In June the College will begin consultations with the profession broadly to determine whether the current guidelines[1] are serviceable, and to identify potential gaps that could be added to the document to improve the referral request/consultation processes. Recent discussions between the College and BC’s Provincial Surgery Executive Committee have already brought to light concerns as they relate to timeliness of communication to patients on waiting lists.

The consultation will also consider whether the document should be strengthened to a legally enforceable practice standard, similar to the directive recently issued[2] by the College of Physicians and Surgeons of Alberta in response to a report[3] regarding a case where a patient died as a result of a breakdown in the continuity of his care.

The College looks forward to hearing more from the profession on this matter in the upcoming consultation, which aims to strengthen the collaborative practice approach that is so essential in patient care.
—Gerrard A. Vaughan, MD
President, College of Physicians and Surgeons of BC
—Heidi M. Oetter, MD
Registrar and CEO, College of Physicians and Surgeons of BC

References Top

1.    College of Physicians and Surgeons of British Columbia. Expectations of the relationship between the primary care/consulting physician and consultant physician. Accessed 12 May 2017. www.cpsbc.ca/files/pdf/PSG-Expectations-of-the-Relationship-Between-Physicians.pdf.
2.    College of Physicians and Surgeons of Alberta. Standard of practice: Referral consultation. Accessed 12 May 2017.
3.    Health Quality Council of Alberta. Continuity of patient care study. 2013. Accessed 12 May 2017. https://d10k7k7mywg42z.cloudfront.net/assets/53275975f002ff4d14000011/Dec19_ContinuityofPatientCareStudy.pdf.


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