Advice

Establishing Protocols for Making Patient Referrals

By Beverly Jue-Smith, OD, MBA
San Ramon, Calif.

QUESTION: What criteria should I use to choose a specialist when making patient referrals?

Answer: As you know, the routine eye exams we perform every day often become the gateway into the healthcare system for many patients. Ocular manifestations of previously undiagnosed or poorly monitored systemic problems, as well as serious ocular conditions, make referrals to specialists a common occurrence in our practices.

As primary care providers, it's our responsibility to establish and maintain protocols for good continuity of care as our patients enter the healthcare system. This will help ensure they receive the comprehensive care they need outside the scope of our training and experience. Remember that your referral choice is a reflection of the level of care you provide, and choosing the right physicians will require you to develop a good working relationship with doctors in your area.

Here's a set of criteria you can use for making patient referrals:

■ Choose a specialist who's part of your patient's healthcare plan. Because medical care is expensive, it's more cost effective for patients to see a doctor who accepts their medical insurance. This increases the likelihood they'll continue to see the professional you recommend for follow-up or ongoing specialty care.

■ Select two specialists from which patients can choose.

■ Ensure a specialist has a good legal track record. Your confidence level in any healthcare professional should depend not only on their clinical skills but on their ability to practice ethically and with integrity. Check to see if the specialist is involved in any disciplinary action. Web sites that offer this information include healthgrades.com and vitals.com/doctors. You can access a physician's record on the American Medical Association's (AMA) Web site or by calling the AMA.

■ Get recommendations from patients who've seen good specialists in the area. Often, word-of-mouth referrals lead patients to some of the best practitioners.

■ Reach out to specialists in your area. Make a list of physicians you'd like to contact and write a letter, introducing yourself and your practice. Follow up with a phone call and an invitation to meet for lunch. Professional relationships can last for many years, so invest the time now to seek and develop relationships with choice specialists.

■ Find out who the general practitioners are using by calling primary care providers in your area, such as pediatricians, family care physicians and urgent care doctors. Ask them which specialists they recommend for endocrine issues, cardiac problems and retinal disorders. Once you have a list of names, you can do your research, contact these specialists and introduce yourself. Soon, you'll have an arsenal of qualified specialists at your disposal. nOD