Interpractitioner Communication: Telephone Consultations Between Rural General Practitioners and Specialists

Abstract

The results of a study that sought to investigate the utility of and satisfaction with telephone consultations from the perspective of general practitioners and specialists are reported. Semi-structured interviews with rural general practitioners and specialists were used to elicit information about their most recent telephone consultations. The telephone was found to be an important means of communication for rural practitioners, primarily in terms of organising referrals. General practitioners tended to called specialists who they knew and appeared to have fairly well-formed networks of specialists who they called for most of their concerns. Trust is an important element of interpractitioner communication as it increases understanding and confidence in the reliability of the information exchanged. Good working relationships ensure that rural general practitioners have an accessible source of acceptable specialist support.

Assessing clinical support and inter-professional interactions among front-line primary care providers in remote communities in northern Canada: a pilot study

“…These were aspects that have been identified as positive predictors of provider retention in rural and remote areas ( 5 , 6 ). Although there exists a large literature on inter-professional interactions and clinical decision-making ( 8 – 13 ), especially between nurses and family physicians ( 14 – 17 ), little has been published in the remote, circumpolar context ( 25 ).…”

“…There is an extensive literature on studies conducted in rural/remote settings involving interactions between primary care practitioners and off-site specialists, the use of multidisciplinary teams, telephone triage, centralized dispatch and other forms of support. A study of telephone consultations between rural general practitioners (GPs) and specialists shows that trust is the key element of inter-practitioner communication as it increases understanding and confidence in the reliability of the information exchanged ( 8 ). A systematic review of GP–specialist interactions shows that most physical health outcomes remain unchanged, although patient concordance with treatment tends to improve.…”

Teleconsultation Improves Primary Care Clinicians’ Confidence about Caring for HIV

“…A few of these programs are geared specifically toward increasing the skill and knowledge base of primary care clinicians and have been generally well accepted by those who use them. [12][13][14][15][16][17][18][19][20][21][22] However, there are few data about how these interventions impact the scope of practice, quality of care, or the subsequent use of specialist services by primary care clinicians, and we are aware of only one study that has measured patient outcomes. 23 To better understand the effect of teleconsultation on primary care clinicians' self-perceived clinical competence and its impact on their utilization of specialist resources, we surveyed users of a long-standing teleconsultation service, the National Human Immunodeficiency Virus (HIV) Telephone Consultation Service (the HIV Warmline) at the University of California, San Francisco.…”