General Practitioners’ Referrals To Adult Orthopedic Services
Journal Title: Eurasian Journal of Family Medicine - Year 2017, Vol 6, Issue 1
Abstract
Aim: Referral is a mean of communication between primary and secondary cares. Musculoskeletal problems are common in the community and the orthopedic departments receive a multitude of primary care referrals. According to the literature, only 58% of referrals to orthopedic services were considered appropriate. The aim of the study is to assess the suitability of orthopedic referrals from primary care. Methods: Compilation of general practitioners referral letters from a randomized selection with duration of five months were studied prospectively. The study included all GP referrals to adult orthopedics clinic in Central Manchester Hospitals but excluded specialized referrals to a named consultant and referrals from other musculoskeletal practitioners. Results: 47 cases were included in the study with an average age of 48. 20 patients had one or more investigations (42.5%). The median waiting time for an orthopedic consult was 7 weeks. Whilst 34% of the patients were sent for further investigations, 23.4% were listed for surgery, and only 12.8% of the patient was discharged from the first appointment. Three patients had mismatching diagnosis. Conclusion: Overall, appropriateness of referrals (91.5%, 4 out of 47) was remarkably high compared to the limited literature. Contributing factors may be attributed to the effective use of established guidelines, easier access of General Practitioners to investigations and imaging in the secondary care or related to General Practice training. Further study into each of the contributing factors may help, and the study perhaps serve as a good model for other regions to improve appropriateness of referrals to secondary orthopedic care.
Authors and Affiliations
Levent Bayam, Karen Chung-Ling Au Yeung, Jonathan Gregory
Keywords
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