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	Institution: CLOCKSS  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 4 No. 5, May 1995   Archives  •  Online Features Special Article  This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal Communication Between Primary Care Physicians and Consultants Ronald M. Epstein, MD Arch Fam Med. 1995;4(5):403-409. Abstract Optimal communication between primary care physicians and consultants includes transfer of relevant clinical information, including the patient's perspectives and values, and provides a means of collaboration to provide meaningful and health-promoting interventions. Communication difficulties arise because of lack of time, lack of clarity about the reason for referral, patient self-referral, and unclear follow-up plans. Also, primary care physicians and consultants may have different core values and may have little day-to-day contact with each other. Poor communication leads to disruptions in continuity of care, delayed diagnoses, unnecessary testing, and iatrogenic complications. Changes in the health care system offer the opportunity for improved collaboration between physicians by creating smaller administrative units within large health care systems that facilitate contact between primary care physicians and consultants; incorporation of discussions of uncertainty, patient preferences, and values into referral letters; adoption of a friendlier consultant letter format; and the improvement of the transfer of clinical data. Author Affiliations From the Program for Biopsychosocial Studies, Highland Hospital Primary Care Institute, and the Departments of Family Medicine and Psychiatry, University of Rochester (NY) School of Medicine and Dentistry. THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES Building Communication Between Professionals at Children's Specialty Hospitals and the Medical Home Stille et al. CLIN PEDIATR 2009;48:661-673. ABSTRACT   Using Computerized Provider Order Entry and Clinical Decision Support to Improve Referring Physicians' Implementation of Consultants' Medical Recommendations Were et al. J. Am. Med. Inform. Assoc. 2009;16:196-202. ABSTRACT | FULL TEXT   Co-management in healthcare: negotiating professional boundaries Schryer et al. DISCOURSE & COMMUNICATION 2007;1:452-479. ABSTRACT   Genetic Services for Familial Cancer Patients: A Follow-Up Survey of National Cancer Institute Cancer Centers Epplein et al. JCO 2005;23:4713-4718. ABSTRACT | FULL TEXT   Coordinating Care across Diseases, Settings, and Clinicians: A Key Role for the Generalist in Practice Stille et al. ANN INTERN MED 2005;142:700-708. ABSTRACT | FULL TEXT   Generalist-Subspecialist Communication for Children With Chronic Conditions: A Regional Physician Survey Stille et al. Pediatrics 2003;112:1314-1320. ABSTRACT | FULL TEXT   Physician Satisfaction with High-Resolution CT Services Provided by Radiologists: Results of a Nationwide Survey of Pulmonary Subspecialists Scatarige et al. Am. J. Roentgenol. 2003;180:585-589. ABSTRACT | FULL TEXT   The Wrong Patient Chassin and Becher ANN INTERN MED 2002;136:826-833. ABSTRACT | FULL TEXT   Quality of Life: Erosions and Opportunities Under Managed Care Morreim J Law Med Ethics 2000;28:144-158.   Coordination of Specialty Referrals and Physician Satisfaction With Referral Care Forrest et al. Arch Pediatr Adolesc Med 2000;154:499-506. ABSTRACT | FULL TEXT   Somatization Reconsidered: Incorporating the Patient's Experience of Illness Epstein et al. Arch Intern Med 1999;159:215-222. ABSTRACT | FULL TEXT   Interspecialty Communication: Overcoming Philosophies and Disincentives Bowman Arch Fam Med 1995;4:401-401. ABSTRACT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 1995 American Medical Association. All Rights Reserved.