The Auckland acute referral process: A survey

Abstract

Objectives: To assess current Auckland general practitioners’ workload regarding acute referrals, perceived problems with the referral process and possible alternative methods of referral. Methods: Data were collected by a postal questionnaire survey of 200 central Auckland general practitioners. Results: A total of 150 responses (75%) were received. General practitioners saw, on average, 120 patients per week (range 10–300) and 1.7 patients per general practitioner per week were sent, as acute referrals, to hospital. Ninety-two per cent of acute general practitioner referrals were preceded by a telephone call to a hospital registrar. The most common problem relating to the telephone call was the length of time the general practitioner spent waiting to speak to the registrar. The call was regarded by many general practitioners as stressful and difficult. In 19% of referrals the general practitioner felt that the patient’s diagnosis was unclear and that further investigations were needed to determine it. Ninety-three per cent of general practitioners regarded an accompanying letter of referral as essential. Forty-eight per cent considered a telephone call to be essential, and 60% believed the call gave added value to the referral letter. Seventy-two per cent of the general practitioners preferred that the acutely ill patients they refer be seen by an in-patient specialty first, rather than by emergency department medical staff. Conclusions: While the general level of general practitioner satisfaction with the current acute referral process in Auckland is not high, there is no consensus among general practitioners about how the process could be improved.