897: Still waiting for a reply to your referral letter....

R.P.J. C. Ramanayaka, R.D.N. Sumanasekera, D.P. Perera, A.H.W. de Silva, L.A.C.L. Athukorala, K.A.T. Fernando
Department of Family Medicine, University of Kelaniya, Ragama, Sri Lanka
Background: Referral and reply letters are an important means of communication between Family Physician and hospital doctors/specialists. Studies describe reply letters as the most neglected route of education for a General Practitioner. Sri Lanka has no standard referral/back-referral system. When we do refer patients, replies from specialists and hospitals are scarce.
Methodology and Objectives: Interventional study designed to identify the referral pattern and to improve the rate of reply for referrals. For six months the rate of response to the normal referral letters were looked at. During the next six months, a structured reply letter was sent to the hospital doctors/specialists attached to the referral letter.
Patents were asked to return the reply letters to Family Physician.
Results: During the first phase, 92 patients were referred and there were no responses from the hospital doctors/specialists. During the second phase, a total of 80 patients were referred to hospital doctors/specialists using the structured referral letter with attached, structured reply form. Reply rate was 8.75 %(n=7). This was an improvement compared to zero replies experienced previously.
Discussion: This was an attempt to improve communication between specialists/hospital doctors and general practitioners in Sri Lanka. Even though there was some improvement it was not satisfactory. Reasons for not replying should be explored broadly and remedial measures need to be taken. In countries without established referral systems, it is necessary that the communication between the primary care doctors and the secondary/tertiary care doctors are maintained in order to provide the optimum service to our patients.

Disclosure: No conflict of interest declared