Desirable Characteristics of Consulting Cardiologists for Sustained Referrals by Primary Care Physicians

• Main Authors: Phillip Ribeiro, Swetal Patel, Krystal Carlos, Sumit Sehgal, Ramdas G Pai, Paulo A Ribeiro
• Format: Article
• Language: English
• Published: Barcaray International 2016-01-01
• Series: International Cardiovascular Forum Journal
• Subjects: degenerated aortic bioprosthesis; valve in valve; left main occlusion
• Online Access: http://icfjournal.org/index.php/icfj/article/view/187/pdf-2
• ISSN: 2410-2636; 2409-3424

Background: Accountable care organization and high quality affordable patient care requires impeccable team work between primary and specialist care physicians. Limited data exists on evaluation of factors that lead to termination of referrals between primary care physicians and cardiologists. Methods Using an 11 point questionnaire of potential factors for cause of termination of referrals to cardiologists, 103 primary care providers were interviewed. Each response was graded by the interviewee on a scale of 1 (least important) to 10 (most important). Mean scores were computed for each of the responses and validated using ANOVA and Tukey’s multiple comparison method. Results Out of 103 primary care providers interviewed in Little Rock, Arkansas and Chicago, Illinois, 84 providers were practicing in the city limits and 19 in the rural areas. The average years in practice for the primary care physicians were 20.9 years. The most important factors for termination of referrals in the order of decreasing importance were cardiologist’s bedside manners as perceived by the patient (7.9 ± 2.1), poor feedback to the primary care provider from the cardiologist (7.8 ± 2.3), and patients not getting their questions fully answered by the cardiologist during the visit (7.8 ± 1.9). Less important factors were the staff’s inability to promptly respond to calls (7.2 ± 2.0), the ease of getting an appointment (7.0 ± 2.3), patient being displeased with the clinical plan (6.6 ± 2.3), staff friendliness (6.6 ± 2.5), physician promptness (5.6 ± 2.6), tests not being done the same day/results not being given promptly (5.6 ± 2.4), cardiologist keeping the patient even if there was only a minor cardiac problem (5.4 ± 3.0), and cardiologist being too aggressive with the tests (4.9 ± 2.6). Conclusions The most important factors that result in termination of referrals between primary care physicians and cardiologists include cardiologist’s bedside manners as perceived by the patient, poor feedback to the primary care provider from the cardiologist, and the patients not getting their questions fully answered by the cardiologist during the visit.