Referral – What a PCP and Patient need to know!

Communication is a critical aspect of healthcare. Most healthcare providers across the country have some system, process, and procedures implemented to ensure smooth flow of communication, but such innovations are largely focused on improving in-facility communication. However, the communication between facilities for most parts remains crude.

The ability to send and receive information between facilities can not only improve the patient healthcare outcome but also enhance healthcare efficiency. A referral management software would simplify the procedures between primary care physicians and patients and helps PCPs to closely monitor the progress or the outcome of the patients who are referred to a specialist.

Problems With Conventional Referrals
1. Physician refer patients but cannot follow up
2. Lack of communication between primary physicians and patients
3. Patients not meeting the referred specialist
4. It is impossible to send follow-up information

Above listed are major issues of the referral. Complexity in the referral procedures starts at the physician’s practice because they are the ones who initiate a referral.

Here are some key points that PCPs are expected to validate before sending out a referral to a specialist.

Get to Know Your Patients More

Knowing a patient is as important as knowing about the problems they have. The patient outcome should be foreseen before a referral is made. A patient visits one PCP whom they trust to a great extent, so when the referral does not qualify their expectations the patients may just walk away.

In some cases, after getting suggestions from a specialist, patients get the second opinion from another physician which is usually a reverse process but this tends to happen often. This shows the importance of PCP in the referral cycle and it is the responsibility of the PCP to ensure patients’ smooth transition and get the required care.

Do Patients Really Need Specialists?

Once a patient selects their PCP they don’t want to see any other physician or specialist unless there is a need. Here PCPs are the generalists who take full responsibility for their patient. Before getting a patient to step into the specialist’s office they must identify a clear need for the specialist’s visit.

Also, general practitioners could solve many of the patient’s problems without the need for a specialist’s help. Only in some cases, physicians require additional visit (maybe twice or thrice) to identify the problem by giving alternative medicines. Even after multiple visits and when they cannot diagnose the problem they will send patients to a specialist at the time of need as they are primarily liable for their patient’s care.

Managing the Referral

To avoid any delay in patient diagnosis some physicians make referrals frequently. But referring more does not always mean it is the right approach.

Mostly referral happens within the network. Physicians send patients to specialists who are known to them and these specialists are easily accessible to them to follow up which helps in closing the referral loop. When this process does not go well as planned then the PCP will stop referring to that particular specialist as referral closure is very important to identify the patient health status.

Key points a patient must be aware of:

1. Referral is an important process in healthcare

2. Referral success partially depends on patient cooperation

3. The referral will require some patient-related data transfer and some methods of data transfer are safer than others.

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Referral – What a PCP and Patient need to know!
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Referral – What a PCP and Patient need to know!
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Problems With Conventional Referrals 1. Physician refer patients but cannot follow up 2. Lack of communication between primary physicians and patients 3. Patients not meeting the referred specialist 4. It is impossible to send follow-up information
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HealthViewX
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