How do we learn?

Abstract

It is, after all, one of the basic skills of general practice – the writing of a referral letter, that all-important link between primary and secondary care. You can find many sorts of referral letter, from the absolute minimum of ‘Dear Doctor, please see and treat’ to much longer letters, badly written and so stuffed with irrelevancies as to mask that which is important. Top of the range, of course, is a letter in which there is proper use of language; the facts – history and clinical findings, and test results – are presented concisely. A diagnosis is put forward together with a note of the referring doctor's concerns and suspicions, and the whole offers a platform on which a consultant can construct an opinion and a plan of action. In my day, at least, such writing was not regarded as a skill to be taught. We learnt it as best we could and, once you entered general practice, it did not take long to realise that the better and more useful letter you would send, the better and more useful letter you would receive. But, as I look back, I wonder how I learnt to write a referral letter. I think …