Is communication improving between general practitioners and psychiatrists?

Abstract

General practitioners and psychiatrists communicate mainly by letter. To ascertain the most important items of information that should be included in these letters ("key items") questionnaires were sent to 80 general practitioners and 80 psychiatrists. A total of 120 referral letters sent to psychiatric clinics in 1973 and 1983 were studied, together with the psychiatrists' replies, and these were rated for the inclusion of "key items." General practitioners' letters contain less information about the family but more about psychiatric history than they did a decade ago. Overall, psychiatrists' letters have not changed. Registrars, however, now include noticeably more "key items" than they did 10 years ago, but their letters remain twice the length of those written by consultants. It is suggested that letter writing skills are vital to good patient management and should be taught to postgraduate trainees in general practice and psychiatry.

Referral letters to an obesity unit—relationship between doctor and patient information

“…It has also been pointed out that the skill of communicating with referral letters is actually never formally taught in medical school 4 and that communication between general practitioners and specialists could be greatly improved with more informative referral letters. 5 In this study we have focused on the problems associated with letters to an obesity unit, where negative stereotypic attitudes by the medical profession to obesity 6 could affect the quality and content. However, we do not know whether the quality of referrals is different for other speciality units.…”

What a general practitioner can expect from a consultant psychiatrist

“…Most formal communication is by letter but telephone contacts are also important as are the impromptu discussions that have become more common as psychiatrists set up consulting sessions in GP's surgeries and health centres. Pullen & Yellowlees (1985) have listed the main information needed by the psychiatrist to be included in the GP's referral letter, and Blaney & Pullen (1989) In the past few years there have been very rapid changes in psychiatric treatments and in the arrangements for delivery of care to patients with mental health problems. New 'community mental health teams' have appeared and 'case manage ment' has become a technical term.…”

Communication between general practitioners and psychiatrists

“…The referral letters of new patients actually seen were analysed. The GPs' letters with the psychiatrists' letters for the same period were studied with regard to a checklist which was devised following a review of previous studies into communication between GPs and specialists (Williams & Wallace, 1974;Pullen & Yellowlees, 1985).…”

“…The items which psychiatrists identified as necessary components of a GP's referral letter include the reason for referral, the main symptoms or problems, the past psychiatric history, the medication prescribed so far and the family history (Pullen & Yellowlees, 1985). GPs identified diagnosis, treatment recommended, follow-up arrangements, prognosis and concise explanation of the patient's condition as items which should be present in a psy chiatrist's letter to a GP (Pullen & Yellowlees, 1985).…”