Are Fears Of Losing Patients Preventing Appropriate Referrals?

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Amanda Wright, Special Projects Editor

   “The whole risk reduction principle hinges on documenting the referral, documenting that the consultation occurred and documenting the outcome. That means your office has to determine when the patient will be seen and that he or she was seen, and it is incumbent on you to get a report from the referral physician what the outcome was. These areas are serious weaknesses in failure to refer cases in which a patient in fact does not follow through and you did not know about it. Any plaintiff’s attorney can seize on that, making you look unconcerned, sloppy, et cetera,” says Dr. Markinson.

In Summary

As a physician, the ultimate goal is to make sure the patient receives the best possible treatment. Dr. Fishco shared a success story about a 63-year-old female patient who presented with pain in her fifth metatarsal. She had also been suffering from lower back pain and was getting epidural injections and physical therapy. Dr. Fishco suspected an element of peripheral arterial disease.

   “I referred her to a vascular surgeon, who called me after seeing her, and said that she had severe aortofemoral arterial disease and had scheduled her surgery for the next week. The patient came back to see me a few months later and just wanted to thank me for saving her life,” says Dr. Fishco.

   Overall, the DPMs who were interviewed for this article reported that 90 percent of all their referral patients returned to them after more specialized treatment with another physician. With those odds, some may find it surprising that some physicians still have a fear of losing referred patients.

   As for the others who don’t return, “frankly, some of the 10 percent I would just as soon not see again,” adds Dr. Jacobs.

   All of the interviewed DPMs would agree that the fear of losing patients is no reason to prevent appropriate and timely referrals. As long as the referring physician is sure to document the referral information and initial consultation, it is likely that a satisfied, trusting patient will return for further follow-up treatment.

   “The bottom line is that it’s not about us but about the patient. If the patient feels more comfortable with the other doctor and wants surgery done by him or her, so be it. All that really matters is that the patient gets taken care of and the outcome is good,” says Dr. Fishco.

   For further reading, see “Building Referrals And Relationships With Primary Care Providers” in the July 2005 issue of Podiatry Today or “Referral Generator: Work Smarter At Patient Education” in the April 2003 issue.

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