Letters from Psychiatrists to General Practitioners

Publisher Website
Google Scholar
Abstract
The need for clear communication in medicine is often stressed, but of all aspects of medical communication probably the least attention is given to that between doctors themselves. The structure of the NHS and the mode of referral from general practitioners (GPs) to specialists mean that the quality of communication between OP and specialist has a strong influence on the way patients are managed and the standard of the care provided. Although it might seem preferable that contact between doctors should be on a face to face basis, this is often not possible. By far the most common mode of communication between GP and specialist is the letter. The most important letter for setting the tone of the partnership involving hospital and GP is that sent by the specialist to the GP after the first assessment visit. This initial letter is the one which reaches the GP at his most receptive, with the particular problem which led to referral fresh in his mind. At times GPs refer patients as much for their own needs as for those of the patient. If the response to his referral leaves the GP feeling his needs are being neither met nor understood, this can undermine the patient's further care and the GP's attitude towards him (Brook, 1978). For some medical or surgical conditions a structured, even pro forma letter may be an adequate and relatively economic form of communication (Leading Article, Lancet, 1973). However, such letters are less suitable in psychiatry, where the greater complexity of problems and their multi- faceted nature create a need for greater length and less structure. Psychiatrists, however, have to ask themselves at what point greater length and lack of structure in letters might actually impede the communication process; and as time (medical and secretarial) is costly, to what extent long letters are appreciated by GPs and thereby justified. In addition, consideration needs to be given to the aims of the letters. Hospital letters have two main aims. The first, as suggested above, concerns the total care of the patient; the second has to do with the educative value of the letter (Cummins et al, 1980). This paper reports an attempt to audit letters by a survey of general practitioners in order to ascertain whether detailed letters were appreciated and whether the aims of the communication were being met.
Keywords

This publication has 0 references indexed in Scilit: