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Doctors need to know a lot. Least of all, they need to know how to help us feel better. So it seems kind of crazy that they’re also expected to know a great doctor who can help with that shoulder pain, or that skin rash, or perform a needed surgery. Why does healthcare depend on our general practitioners to act as Yelp for specialists?

Proper physician referral processes allow doctors to focus on what's most important: the patient.Okay, so that might be an exaggeration, but healthcare does work like that on some level. Only it’s not working. Instead, general practitioners write a referral request for a patient, but they don’t know who is covered by the patient’s insurance. The request might get entered into an EMR if it exists, and chances are the patient never schedules the appointment. Or maybe the patient doesn’t know where to look, so she looks outside the system. That’s what we call leakage, money lost for the health system, and there is now a disconnect in the patient’s care. Doctors from different health systems on different EMRs will not be communicating about medications and care. This is not holistic. This is not great for patients.

In an ideal world, referral management works seamlessly. A patient leaves the general practitioner’s office with an appointment to meet with a specialist already scheduled. The GP has probably conducted some tests or had lab work done, and the results of those tests are entered into the EMR so that the in-network specialist has access to those results. No more repeated testing, no more associated costs.

Then, once the specialist has seen the patient and prescribed new methods of care, those new medications are entered back into the EMR for the general practitioner to review. This helps create a holistic process of caring for the patient; each doctor can see what the others are doing to help each individual patient. This ideal process is safer, cheaper, and provides better care. Creating this ideal is a lot of work and takes a lot of process review to make it happen, but it’s one of the most important initiatives a health system can start.

Doctors need to know a lot. Let’s take away some of the distractions and help them focus on their number one priority: helping people get and stay healthy.

Photo from Wikimedia Commons.

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