Where have all the copy letters gone? A review of current practice in professional–patient correspondence

Abstract

2 ObjectiveThis article reviews the literature in relation to patients receiving copies of health professional correspondence. It examines progress in adopting the practice three years on from its introduction as policy in the UK, and considers potential benefits and obstacles to implementation. MethodsA review of the literature on copy correspondence, accessed via Medline, PubMed, CINAHL and also online resources, using the search terms "patient letter", "copy letter", "copy correspondence" and "doctor letter". ResultsStudies describe a range of benefits from copying letters, but implementation remains inconsistent, ranging from 8% to 87% of patients reporting receiving copy correspondence. A number of concerns are identified which may be delaying whole scale adoption of the policy by health professionals. ConclusionThis paper argues that researchers should move from examining the benefits and concerns around copying letters to patients, and instead focus on exploring the quality of correspondence and the optimum process of implementing the practice. As patients can "opt out" of receiving copy correspondence, current audit of service delivery may be problematic in not taking account of patient choice. Practice implicationsCopying letters to patients may have a number of important benefits and should be routine practice where patients wish to receive correspondence. Future studies examining patient preference regarding the style and content of letters would be helpful, and there is a need for studies in non-medical professions. Mechanisms for 3 recording patient preference need attention, with further consideration of methods for auditing of the practice.

Impact of providing patients with copies of their medical correspondence: a randomised controlled study

“…The provision of medical correspondence to patients has been suggested to improve shared decision making and promote the empowerment of patients . Consequently, the United Kingdom National Health Service (NHS) proposed a policy in 2000 outlining that ‘letters between clinicians about an individual patient's care will be copied to the patient as of right’ (NHS Plan, Paragraph 10.3) . This policy highlighted the need to provide patients with the option of receiving their medical correspondence.…”

Differences in BRCA counseling and testing practices based on ordering provider type

“…28 Prior studies have indicated that copying of correspondence to patients is associated with a range of benefits including greater patient understanding, greater patient involvement, reduction in anxiety, increased satisfaction, and more accurate risk perception. 29,30 Furthermore, a letter provides something that patients can share with relatives. 31 …”

No Change in Physician Dictation Patterns When Visit Notes Are Made Available Online for Patients

“…This observation is consistent with observations made by Golodetz 12 more than 3 decades ago that "80 percent of patients felt they had understood enough to satisfy themselves." In a recent review, Baxter et al 33 noted that most of the reviewed studies demonstrated that patients accept medical terminology.…”