Risk Management Tip: Promoting Communication Between Referring and Consulting Physicians

MLMIC Risk Management Tip #12 addresses medical professional liability risks related to “Promoting Communication Between Referring and Consulting Physicians.”

The Risk

Lack of communication between providers may result in poor coordination of care. This may include a delay in diagnosis or treatment, the failure to order diagnostic testing or act upon abnormal test results, or the failure to prescribe appropriate medications. Clearly defining the roles and responsibilities of the referring and consulting physicians will promote safe and effective patient care.

Recommendations

1. A tracking system should be in place to determine if the patient obtained the recommended consultation.
2. Referring physicians should develop a process for determining whether a report has been received from the consulting physician.
3. All consultation reports must be reviewed by the referring physician prior to being placed in the patient’s medical record.
4. If a patient has been non-compliant in obtaining the recommended consultation, follow-up is necessary. Document all attempts to contact the patient and any discussions with the patient, including reinforcement of the necessity and reason for the consultation.
5. If a report is not received in a timely manner, contact the consultant to determine if the patient has been seen and whether a report has been generated.
6. Consultants should routinely send reports to referring physicians in a timely manner. These reports should include the:
   • findings;
   • recommendations including interventions; and
   • delineation of provider responsibility for treatment and follow-up of test results.
7. The consultant should contact the referring physician when a patient fails to keep an appointment. The medical record should reflect the missed appointment, as well as notification of the referring physician.
8. All telephone conversations between referring and consulting physicians should be documented. Timely communication must occur when an urgent or emergent clinical finding is identified.

This MLMIC Risk Management Tip is available here as a PDF: “Promoting Communication Between Referring and Consulting Physicians.”