Secrets to Effective GP/Specialist Relationships
Following these five steps can foster a spirit of cooperation and boost collaboration.
Mrs. Jones’ dentist told her that he wished to refer her to a specialist. That’s when the trouble began. The first indication that something wasn’t right occurred when the specialist’s office took longer to schedule her consultation than she expected. When she arrived, the doctor gave her different treatment options and timelines than her dentist had. And, the fee was slightly higher than what her dentist had said it would be, which didn’t add to her comfort level. When she returned to her GP’s office, she was suspicious of the specialist, and her dentist was annoyed with the specialist, who apparently had not communicated certain specifics when the two offices were in contact. What the GP didn’t know was that the specialist was equally frustrated by the lack of information received from the GP’s office.
An Unfortunate Situation
Is anyone happy in this case? The answer is, emphatically, “no.” However, although unfortunate, this situation is hardly unique in interdisciplinary situations.
Effective collaboration is critical to successful interoffice treatment for both GPs and specialty practices. Without this collaboration, patients become unhappy and may not receive treatment. Given the result in Mrs. Jones’ case, a standardized approach is needed.
Effective collaboration depends on a system that can be employed by any specialist or restorative dentist to enhance patient results and clinical quality—both of which have a profound effect on practice productivity. The goal is to focus on the total treatment process (both clinical and non-clinical) to create a superior experience for the patient, the specialist, and the restorative doctor. Successful collaboration allows practices to achieve superior outcomes and maximum efficiency, while lowering stress and increasing production for both practices.
Five Steps to Successful GP/Specialist Relationships
Effective interoffice collaboration results in patients receiving excellent clinical care and the most positive experience possible. The actual treatment is rarely the issue. Rather, it is the patient’s experience before and after treatment where the greatest challenges occur.
Too often, patients get lost in the shuffle between practices. When the referral process is dysfunctional in any way, the entire referral process should be analyzed and redesigned in five stages.
Define the Relationship
To create more productive interoffice communication, the following protocols should be discussed and agreed on between the referring doctor and the specialist.
- If necessary, a pre-conference between the two doctors should take place.
- Appropriate patient information is provided to each doctor.
- Determine whether the new patient is seen by the doctor or a treatment coordinator.
- Reach agreement on which services necessitate one consult and which necessitate two or more.
- Decide if other specialists will be involved.
- If the patient agrees to treatment, ascertain how quickly he or she can be seen.
- The specialty practice will decide the time frame for the consultation and treatment appointment.
- Discuss what financial options are available in the specialty practice and restorative practice respectively. Are they complementary?
- Is patient financing available in both practices?
When these protocols are consistently observed, an effective referral process is the result.
Develop a Communication Plan
Specialists and restorative doctors should agree to a communication plan. Some prefer the immediacy of e-mails or secure Web sites that are designed to handle confidential information. Others may prefer the formality of actual letters. Phone calls can be necessary to convey complex information more clearly than written communication or to discuss urgent situations.
This ongoing communication between the two offices will be evident to patients. For example, nothing can be more destructive to the referral process than patients having a piece of information that wasn’t properly conveyed to the referring doctor, as happened in Mrs. Jones’ example. Too often, patients return to the referring office feeling awkward and are quickly convinced that the two practices are not on the same page.
Schedule Regular Communication between Offices
These conversations should have clear objectives, as follows.
- The specialty practice has received sufficient information about referred patients (other than an x-ray and a treatment recommendation).
- There are any obstacles in designing a treatment plan for this patient or meeting the expectations of the restorative doctor.
- The final treatment plan is in the patient’s best interest.
- The patient is receptive to recommended treatment.
- The patient can handle the financial obligation.
These discussions are critical interpractice communication, serving to facilitate excellent teamwork, foster better decision-making, and build stronger relationships between all parties.
In addition to preparing a final report for the referring doctor, specialty practices should also facilitate scheduling patients back in the general practice to ensure that they are seen for their final restorative care or posttreatment hygiene appointment. As always, specialists should offer whatever assistance patients need to successfully transition back to the general practice.
It is also highly beneficial for specialists to verbally give their endorsement to the restorative doctor even though the patient is a regular participant in that practice. The more confidence patients have in their dentist, the more likely they will comply with posttreatment recommendations and enjoy greater oral health.
Assess the Results
The treatment results are carefully assessed by the referring doctor to ensure that the final restorative case can be completed as originally planned. The final treatment plan is reviewed once again with patients so that they understand all aspects of proper home care.
In a true interdisciplinary experience, the restorative practice will inform the specialist of the result as well as any challenges that took place in restoring the case. This level of communication provides closure for the case, but also serves as a learning opportunity if any challenges occurred or changes need to be made.
Excellent interoffice communication can prevent experiences like those of Mrs. Jones. When two offices work constructively together, they can both enjoy excellent results. Patient care remains at an optimal level, and the patient experience is universally positive. In addition, both practices benefit from generating a positive reputation and, as a result, increased productivity.
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Roger P. Levin, DDS
Dr. Levin is the Chief Executive Officer of Levin Group in Owings Mill, Maryland.