Risk Tip: He said, she said: Patients, doctors seem to agree that docs should communicate better

Someone doesn’t think you’re doing a good job at communicating? Physicians and patients alike are noticing the need for improvement among physician-physician interactions.

A recent survey of physicians in the Archives of Internal Medicine showed that nearly 70 percent of primary care physicians report sending patient history and consultation reason to specialists, but less than 40 percent of specialists say they receive such notification. Similarly, over 80 percent of specialists say they always send consultation results to the referring physician, but only 60 percent of primary physicians say they receive them.

Patients also are taking notice. In a recent survey by Lake Research Partners, almost 75 percent of adults age 50 and older say they wish their doctors communicated better with each other. Findings from this group of patients include:

• 13 percent said they had to have a test or procedure repeated because the doctor or hospital did not get the results of the first test or procedure.
• 40 percent of patients with multiple chronic conditions and 29 percent of those without such conditions said they have had to serve as the communicator between their doctors.
• 36 percent of heavy users of the health care system and 20 percent of patients overall say they have received conflicting information from different doctors.
• 76 percent of heavy health care users said they have left a doctor’s office or hospital confused about what they should do when they get home.

• Review or implement effective referral and test tracking systems.
• Ensure that all members of your office staff know how to reconcile tests, referrals and consult orders with the results when received. If a discrepancy occurs, have a process in place to remedy it promptly before an adverse event occurs.
• Revisit and confirm coordination of care and treatment strategies with colleagues.
• Provide for patients an easy to understand and thorough informed consent process.
• If using an electronic medical record, utilize the test tracking capability as designed.

• Do not rely on a return appointment or placing a “hold” on the medical record to act as a reminder that a test was not performed or the patient was not contacted about results.
• Engage the patient in following up for test results. Tell the patient to contact your office if he or she has not received results from you or your office staff by a specified date.
• Communicate all test results to patients, including those that are within normal limits (WNL).
• Use a recall system for those patients who are regularly seen.
• Send letters to patients who fail to follow up and cannot be reached by phone. File all documentation and copies of letters in the medical record.
• Utilize a mechanism to ensure patient understanding, such as Ask Me Three™ (npsf.org/askme3) or the teach-back method.

Contributed by The Doctors Company. The Doctors Company is the exclusively endorsed professional liability insurer for members of the Ohio State Medical Association. For more information on the OSMA's partnership with the Doctors Company, click here.