For many patients, a visit to a primary care physician is only the first step in the journey get getting the medical treatment they need. If they need specialized treatment that requires a referral to a specialist, it could be months before their treatment plan is in place.
According to a study conducted in California that was published in the New England Journal of Medicine, patients needing to be seen by a gastroenterologist often wait 11 months from their initial visit with their PCP before getting the treatment they needed. Although that is an extreme example, navigating the healthcare system is often frustrating and inefficient. Some of the greatest issues in the physician referral process are as follows:
- Unnecessary delays in patient care. Sometimes the physician doesn’t reach out to the specialist in a timely manner, causing unneeded delays to the patient’s treatment. Sometimes, the specialist is slow to respond, observe, and provide treatment to the patient. Each delay piled on top of the last drags out the length of time it takes for a patient to receive the care they need.
This can be avoided by making an agreement with all parties involved in the referral network with appropriate turn around times for each step in the referral process, and performing audits annually to ensure it is being met. Many websites for doctors include medical referral tracking software that performs such audits in real time and keeps all parties in communication to ensure efficient treatment for the patient.
- Inefficient referral processes. Medical practices who don’t use healthcare referral management software and process referrals on paper have a number of bottlenecks.
The paper referrals are sent through the mail, which requires additional time and sometimes can’t be tracked down. Since the communication piece that healthcare referral management software offers doesn’t exist with manual referrals, missing or incomplete information can cause delays or mistakes. The receiving specialist only gets the limited amount of information about the case that is included on the paper referral, requiring the patient to convey the details, which can create misinformation and treatment mistakes.
- Too much guesswork is involved in the process. Many times physicians don’t ask the right questions to get a full picture of the patient’s condition, and fill in the blanks with assumptions. Often, the tests that were performed and notes that were taken are not conveyed to the specialist, which creates more room for guesswork. This is especially problematic for patients with extensive medical histories.
The best situation involves using healthcare referral management software that has a database of information about the patient that any doctors who are providing care should review and update regularly, so that all parties have a complete picture of the patient’s condition.
- Poor communication. The relationship between the physician and the specialists should function as a team, working together to solve the medical issues the patient is experiencing. The specialist is not a do-over, where the patient has to start from scratch again, hoping to find the solution this time around. The physician should provide a detailed account of observations and treatments taken already, the specialist should pay attention to it, to be brought up to speed on the care plan in place.
Ideally, the physician and the specialists in his referral network will collaborate, each bringing their own strengths to the game, to find the best treatment for the patient. When this isn’t the case, the patient pays the price.