Disorganized communication between emergency room doctors and primary-care physicians can undermine effective care, a new study by the Center for Studying Health System Change finds. This poor coordination compromises patient care through duplicative treatment and misapplied treatment.
The DC-based think tank matched 21 pairs of ER and primary-care doctors working out of the same hospital and found that patients' physicians rarely contact the emergency room on their own, even if they send the patients to the hospital. Likewise, ER doctors hardly ever contact the primary care doctors to clarify information or discuss treatment plans.
Both physician specialties agreed that efficient interaction would ensure patients were safely admitted or discharged with a follow-up plan, notes the Seattle Times. Without it, "Sometimes you get patients back, and they were put on a medication they didn't tolerate a year ago, and they are back at square one," one PCP said in the study.
But sharing medical information between PCPs and EPs is difficult. Telephone calls required multiple pages and lengthy waits for callbacks, faxed records were long and hard to read, and electronic records were either incomplete or irrelevant to the particular problem, according to the findings.
"There are no easy answers to the coordination issues between emergency and primary care physicians," said the study's senior research Dr. Emily Carrier, notes the Seattle Times. Although she thinks the reform efforts will give doctors more financial incentive to better coordinate treatment.