Who is checking the quality of referrals? College replies

Issue: BCMJ, vol. 59, No. 5, July August 2017, Page 297 Letters
By: Gerrard A. Vaughan, MD Heidi M. Oetter, MD

The College would like to thank Dr Holtby for his submission to the BCMJ regarding the quality of information provided by a referring physician on behalf of their patient.

The College would like to thank Dr Holtby for his submission to the BCMJ regarding the quality of information provided by a referring physician on behalf of their patient. While physicians seldom raise this as a formal matter with the College, his views are undoubtedly shared by many in the profession—both consulting and primary-care physicians alike.

The College agrees that in a patient-centred health care system, physicians have a duty to provide clear and comprehensive request-for-consultation letters supplemented by supporting documentation.

Likewise, consultants have a duty to provide a timely response to the referring physician acknowledging the request, as well as a report. The College would go further to say that communication should also be delivered in a timely manner to the patient.

Dr Holtby’s letter is well timed. This June the College began consultations with the profession broadly to determine whether the current guidelines[1] are serviceable, and to identify potential gaps that could be added to the document to improve the referral request/consultation processes. Recent discussions between the College and BC’s Provincial Surgery 

Executive Committee have already brought to light concerns as they relate to timeliness of communication to patients on waiting lists.

The consultation will also consider whether the document should be strengthened to a legally enforceable practice standard, similar to the directive recently issued[2] by the College of Physicians and Surgeons of Alberta in response to a report[3] regarding a case where a patient died as a result of a breakdown in the continuity of his care.

The College looks forward to hearing more from the profession on this matter in the upcoming consultation, which aims to strengthen the collaborative practice approach that is so essential in patient care.
—Gerrard A. Vaughan, MD
President, College of Physicians and Surgeons of BC
—Heidi M. Oetter, MD
Registrar and CEO, College of Physicians and Surgeons of BC

References

1. College of Physicians and Surgeons of British Columbia. Expectations of the relationship between the primary care/consulting physician and consultant physician. Accessed 12 May 2017. www.cpsbc.ca/files/pdf/PSG-Expectations-of-the-Relationship-Between-Phys....

2. College of Physicians and Surgeons of Alberta. Standard of practice: Referral consultation. Accessed 12 May 2017. www.cpsa.ca/standardspractice/referral-consultation.

3. Health Quality Council of Alberta. Continuity of patient care study. 2013. Accessed 12 May 2017. https://d10k7k7mywg42z.cloudfront.net/assets/53275975f002ff4d14000011/De....

Gerrard A. Vaughan, MD, Heidi M. Oetter, MD. Who is checking the quality of referrals? College replies. BCMJ, Vol. 59, No. 5, July, August, 2017, Page(s) 297 - Letters.


Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply