I send letters to other doctors, pretty religiously. I know this isn’t required, and some have stopped doing it.
To me, though, it isn’t just a courtesy. It’s good patient care. If an internist referred a patient to me, I assume they’d want to know what I think, what tests I’m ordering (and what they showed), and what, if any, treatments I’m prescribing. They’re also going to want to know this from me, and not the patient, whose recollection may not be accurate ("he ordered tests and gave me a white pill").
It saves money. I make sure test results from my orders are sent to them, so things don’t get duplicated and they’re up to date on my findings. Likewise, I hope they’ll copy me with relevant records.
It improves safety. Most of a patient’s medications are going to come from their internist, so it’s important they know what I’m prescribing. Drug interactions can be a serious problem.
Realistically, I’m not expecting anyone to read my entire note. I think most (like me) skip to the impression. That’s okay. The point is to know what others are doing. We’re all supposed to be working together to help Mrs. Smith get better, aren’t we? That’s not easy when you have no idea what’s going on elsewhere on the field.
One particular irritant I have is a major neurologic center in my town. Every now and then I have an unusually complex case and refer patients there for a second opinion ... and never hear back.
This drives me nuts. Sometimes the patients return to me, and to figure out what was done, I have to send over a release for records, which can take a week or two to get back. I’m also curious, for my own education, to know what they thought and what the final diagnosis was. Learning about the cases I didn’t figure out helps make me a better doctor.
Communication is a critical feature of our species. And, among doctors, I believe it leads to better patient care. I hope that my obsession with it is good for all involved, and I wish others felt the same way.
Dr. Block has a solo neurology practice in Scottsdale, Ariz.