Re: Who is checking the quality of referrals? College replies

Issue: BCMJ, vol. 59, No. 8, October 2017, Pages 394-395 Letters
By: Mike Figurski, MD, CA-CPHIMS

I applaud the College’s efforts to improve asynchronous communication between physicians for consultations [BCMJ 2017;59:256].

I applaud the College’s efforts to improve asynchronous communication between physicians for consultations [BCMJ 2017;59:256]. I find inordinate delays in health authority transcription to be the major factor in critical delays for emergency patients. I sent a letter regarding a man with suspected aortic dissection to our tertiary hospital on 9 August with a full consult letter the same day after full workup. The receiving physician dictated a comprehensive, appropriate reply, which I received by fax on 16 August (likewise added to the EHR). The letter indicates a 7-day delay between dictation and transcription. I have no doubt that the Interior Health Authority (IHA) is working hard to improve this turnaround time, which I consider to be a dangerous practice for patient safety. The patients present back to my practice during the week, and I have no idea what the findings or treatment plans were because transcription takes a week. These timelines are typical in my experience.

I wondered if any standards were set for transcription times, and whether emergency physicians or IHA in-house consultants are obliged to use third-party dictation services when transcription times are dangerously long.

Perhaps there is a role for physicians to develop communication channels outside of the health authority. 

Physicians are considered independent contractors and must meet professional and College standards. I would welcome any suggestions on how to do so within the current framework.
—Mike Figurski, MD, CPHIMS-CA
Big White, BC

The Interior Health Authority declined to provide a response, but has indicated that they will contact Dr Figurski directly regarding the incident he describes in his letter.—ED

Mike Figurski, MD, CA-CPHIMS. Re: Who is checking the quality of referrals? College replies. BCMJ, Vol. 59, No. 8, October, 2017, Page(s) 394-395 - Letters.


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