title: The referral process: a study of one method for improving communication between rural practitioners and consultants.
abstract: Communication between referring physicians and consultants, essential for successful completion of the consultative-referral process, was inadequate in a rural clinic. This finding prompted the authors to conduct a randomized prospective trial of a referral form and return mailer in three rural primary care clinics associated with a university medical center. The use of a return mailer increased the percentage of consultant feedback from 39 percent to 60 percent, a highly significant increase. An added benefit was a decrease in the median time interval between a patient's contact with a consultant and receipt of that consultant's report by the rural clinics. The positive effect of the return mailer was consistent among various consultant categories, with the greatest improvement coming from a teaching hospital Emergency Room. The type of referring provider or the emergency status of the patient did not affect the percentage of communications returned. The use of a referral form accompanied by a request for feedback and a return mailer is an inexpensive method of increasing communication between primary care providers and consultants, thereby enhancing the value of the consultative-referral process.
mesh_terms: D000554:Ambulatory Care Facilities; D003142:Communication; D005246:Feedback; D005431:Florida; D006801:Humans; D008722:Methods; D011320:Primary Health Care / Q000379:methods; D012017:Referral and Consultation; D012424:Rural Population