A look at the two–way referral system: experience and perception of its handling by medical consultants/specialists among private medical practitioners in Nigeria

Abstract

Background A two way referral system is an organized two way relationship between a health care provider or physician in a health care facility at one level of the health care system and another health care provider or physician in a health care facility at the same or higher level of the health care system In a two way referral system there ought to be effective communication between physicians at the same or different levels of the health care system It is obligatory for the referring physician to refer a patient promptly in a manner that guarantees efficient cost effective optimal and quality care for the patient It also requires the physician in the receiving hospital health care facility to refer the patient back after treatment to the health care facility or physician that initiated the referral in the first instance with clear feedback on the observed findings investigations conducted for the patient and the treatment given to the patient This aids effective continuity of care and also updates the referring physician rsquo s knowledge Since an effective efficient and integrated referral system is vital to the performance of Nigeria rsquo s healthcare system the importance of the practice and perception of the two way referral system by Private Medical Practitioners in Nigeria particularly as it affects their relationship with Medical Consultants Specialists cannot be over emphasized Objective This study assessed the practice and perception of the two way referral system by Private Medical Practitioners in Nigeria with the hope of providing valuable information that will help improve the practice of the two way referral system in Nigeria particularly through an enhanced relationship between Private Medical Practitioners in Nigeria and Medical Consultants Specialists Methods This was a cross sectional survey of Private Medical Practitioners in Nigeria to assess their self reported practice and perception of the two way referral system Data were analysed using the Statistical Package of Social Sciences version IBM SPSS Chicago IL statistical software with Pearson rsquo s chi square used to determine associations between variables Statistical significance was set at a P value of lt Results There were respondents with males and females M F The age range of the respondents was yrs with a mean age of plusmn yrs Majority of the respondents had practiced for more than yrs while majority practiced in only a private health facility Only of the respondents claimed not to be aware of the two way referral system while were extremely aware Most of the respondents had good knowledge of the two way referral system of the respondents claimed they have never received a backward referral letter or feedback from medical consultants specialists after referral of patients to them while claimed to have received sometimes Out of those who reported they got feedback less than one third got a feedback only when they requested for it Though more than half of the respondents were not at all satisfied with the handling of referrals by Medical Consultants Specialists in Tertiary Teaching Hospitals and almost half rated the handling of referrals by Medical Consultants Specialists to be poor majority strongly agreed that the two way referral system is relevant to the health care delivery system Conclusion The two way referral system has the potential to significantly strengthen Nigeria rsquo s healthcare system through effective participation and synergy between Private Medical Practitioners and Medical Consultants Specialists Although Private Medical Practitioners in Nigeria may have good awareness and knowledge of the Two way referral system their experience and perception of the handling of referrals by Medical Consultants Specialists is poor