Differences in the value of clinical information: referring physicians versus consulting specialists.

Background: We investigated differences in the value of clinical information communicated between referring physicians and consulting physicians in the setting of shared care of patients who had chronic problems.

Method: An 18-item questionnaire included items that measure the value of information received from the other physician, referring and consulting physician roles, preference for method of communication, and content of communication. Questionnaires were mailed to a study sample consisting of 200 referring family physicians and 200 consulting specialists. The overall return rate was 44 percent.

Results: We found that both referring physicians and consulting physicians assigned high value to all categories of information, but (1) consulting physicians value information received from referring physicians less than referring physicians; (2) both referring physicians and consulting physicians rank the value of definition of roles and specific monitoring procedures below other aspects of the consultation process; (3) both referring physicians and consulting physicians express a preference for initial verbal communication followed by written reports; (4) referring physicians and consulting physicians assign equal priority to information about current medications, health beliefs and attitudes of patients, drug details including sensitivities, and matters that the patient is not likely to discuss with consulting physicians; and (5) consulting physicians assigned less value than referring physicians to reasons for referral, chief symptoms and symptom chronology, referring physician findings, and referring physician diagnosis, though both rate all these items relatively high.

Conclusion: There appears to be a need for referring physicians to improve the quality of information provided to consultants. New educational strategies must be addressed to enhance quality medical management in the setting of shared care.