Patient referral is a common and important medical practice. Infact, we have to know that referral is a part of patient's treatment and not a show of how less powerful you are.
WHEN SHOULD U CONSIDER REFERRAL??
1. When you can't make the diagnosis:
There will be times when, no matter how hard you try, you just won’t be able to determine how to best help a patient especially if you don't know what to treat (the diagnosis).
The diagnosis is quite sacrosanct in treatment. Don’t stress yourself, because there are other colleague out there that can help you probably because they are more experienced than you are and so on. This isn’t a defeat, it is a mutual goal to diagnose a patient in the most efficient way and treat same.
Consider referring your patient if you find yourself in this situation. Applying polypharmacy or doing trial and error method could be harmful or lead to late referral.
2. When they need a specialist's opinion:
They say two heads can be better than one. Sometimes, you might need to refer to a specialist. Don't be "I know all or I too know kind of person". Specialists often can have a different opinion that might benefit the patient.
If you see that your patient has risk factors, or if you simply want a second opinion, a referral to a specialist might be the way to go.
Don't be proud!!! Specialist referrals don’t necessarily hurt your patient retention, because you are still involved in the patient’s journey of health.
The priority is to save the life of the patient at a reduced cost as possible.
3. When they know a patient will click better with a fellow physician:
Every doctor comes across a patient they don’t see eye-to-eye with once in a while. Some patients don't just like you or you too might not feel good with certain patients for a variety of reasons, but you should always first try to work through any problems in order to deliver care to the best of your ability. If it is not working, Send them to another person they feel more comfortable with.
If nothing is working — if you just can’t get through to them — it might be time to refer the patient to a colleague you think they will better vibe with. Refers like this could be mutually appreciated. Don't be proud!!
4. When they want to improve patient access:
Patient access includes convenience of location, availability of appointments, and the language the doctor speaks.
If you find yourself in a situation where it is difficult to communicate with your patient, or you are overbooked and can’t see them in a timely manner, they feel stressed because of distance, referrals could be the solution.
5. When a patient’s condition is outside a doctor’s/Nurses' area of expertise.
6. When the patient's condition requires a place with more facilities.
GUIDELINES FOR REFERRAL
1. Determine and document the reason for the referral in the patient’s medical record.
2. Before contacting the other physician, explain to the patient why a referral is necessary, including what the patient should expect from their visit with the specialist or the place you are referring them to.
3. Allow time for questions, and encourage the patient to ask questions during the referral appointment. Some may think that you have known that they can't make it and so they are afraid when you mention referral. Explain well and win their confidence.
4. Document that the patient has been properly informed.
5. If the referral is critical(patient is in a critical health state) , the office staff should make an appointment before the patient leaves. The patient should be given the information about the specialist, including the address and directions.
6. Contact the specialist directly to discuss the referral and other necessary things you want.
7. Provide information on the patient’s current situation, as well as other medical records, test results, and documents to avoid duplicate effort.
8. Agree on the urgency of the referral, how long the process might take, how often to communicate, and who will manage the patient during the referral timeframe.
Followup every case you refer to know their health progress and final outcome.
CHALLENGES OF REFERRAL
1. Conflict of commission: When we refer a patient to another facility, we expect a rebait or commission from the hospital they referred the patient to. Sometimes, if such agreement is not met, it affect the zeal to refer. However, life is very precious and you can't afford to lose a life just because of commission. The priority here is the life.
2. Patient's refusal: Some patients refuse referral and most of the times, try to persuade you to retain them and keep trying your best even when you have exhausted your best.
You must learn to insist on your medical advice especially when you know the life is threatened. Take time to convince them otherwise.
3. Distance: Sometimes, place of referral might be too far and means of transportation too is unfriendly.
Early referral can solve a part of this challenge.
CONCLUSION
Although it might be a tough goodbye to make a referral, sometimes it’s the best solution(option). Patient satisfaction could increase, and your practice might see more referrals from current patients who are more satisfied with their overall care.
Writer:
Nr. Elugu Christian RN, RNE, RGN, BNSc, PGDE, CEO CDT.
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