The GP—hospital interface: attitudes of general practitioners to tertiary teaching hospitals

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Abstract
Objective To assess general practitioner (GP) perceptions of liaison with two local tertiary teaching hospitals. Design Questionnaire‐based survey of GP attitudes. Setting Melbourne and North West Melbourne Divisions of General Practice, in July and September 1994. Participants All GPs (587) practising in the Divisions (identified from Health Insurance Commission lists of consultations charged at GP rates). Outcome Measures Degree of agreement on a 5‐point Likert scale to statements about GP—hospital liaison, and relevant open comments. Results 350 GPs (60%) responded, including 84% of vocationally registered GPs; 68% of the 350 were in full‐time practice and 70% had been in practice for over 10 years. GPs had no clear strategy for obtaining admission of semi‐urgent patients to public hospitals. For patients needing urgent admission, almost a third of GPs sometimes resorted to sending them to the emergency department without first telephoning. Most GPs agreed that hospitals did not notify them of patient admission (84%), major changes in patient condition, including death (87%), and patient discharge (75%). Most would interrupt a consultation to discuss a patient with hospital staff (92%). About half agreed they had poor access to outstanding results, and 65% were concerned that proposed early‐discharge practices would be detrimental to patient care. Conclusions The survey identified considerable GP dissatisfaction with hospital—GP communication and GP willingness to be more involved in liaison and communication with hospitals about patient care. Changes in hospital organisation and hospital staff attitudes are needed to allow this.