When referring to specialists, keep these 3 things in mind

Referring physicians are critically important not just for the care and attention we provide patients but also for the referrals we make to specialists. Patients don’t have access to the same data or knowledge that we as healthcare professionals possess, so as referring physicians we can have a significant impact on our patients’ health after they’ve left our immediate care.

Big data has given us more information than ever in making those referrals to help our patients find the “right” doctor with the appropriate clinical expertise for their condition. But what else should physicians take into account when making those referrals?

Here are three factors physicians should keep in mind when referring patients to specialists:

1. What’s behind the reputation of the physician in this specialty? Are they “Dr. Famous” because they published articles on this type of procedure but haven’t actually performed it in 15 years? Or is it a procedure they perform often enough to provide a deep familiarity and high skill level? A long list of publications on a specific topic may matter, but in the high-dexterity world of procedural medicine, regular hands-on experience may matter more.

2. Location matters. The setting where the procedure will be performed is very important: Will the patient be referred in-network or outside? This is particularly important when the patient’s condition or required procedure is not routine. Referring within a network in which physicians all use the same EMR is critical so that the patient’s clinical data can be easily and quickly shared. In fact, referring a patient to a physician who might be less well-known but who has access to the patient’s medical records is likely more important than referring to “Dr. More Famous” at an out-of-network health care system. Of course the key is to be able to initiate such a consultation in an efficient, expeditious and data-driven way.

3. Is the referring physician new to the health system? That can be a challenge because the referring physician doesn’t yet know the specialist physicians who are nearby, in-network or expert in a given procedure or condition. I remember during my own career, after moving to a new state and needing to refer a sick patient for an ERCP — a potentially high-risk invasive gastrointestinal procedure — I was forced to search high and low to find a list of possible specialists. After three phone calls and plenty of wasted time, I finally found an interventional gastroenterologist who accepted my patient’s insurance. But I was ultimately frustrated with the experience and felt that the relevant data should be much more on-demand for these critical interactions.

A systematic approach to referrals should take into account both the data, as well as these more qualitative factors.

Mark Krivopal is an internal medicine physician and vice president of clinical programs, Kyruus.

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