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Dermatologic Clinics Oct 2023Dermatology referral utilization is increasing, with 15% of dermatology-related visits by primary care resulting in a dermatology referral. Given this, both... (Review)
Review
Dermatology referral utilization is increasing, with 15% of dermatology-related visits by primary care resulting in a dermatology referral. Given this, both strengthening an expanding a referral is a key component of a successful dermatology practice. In particular, effective communication is essential for efficient patient-oriented coordinated care. Written and/or verbal communication can help build a strong communication network and, in some instances, can be applied toward Merit-based Incentive Payment System (MIPS) reporting and billing for coding families that incorporate the coordination of care. Reaching out directly to referring clinics has also been shown to increase the quantity of referrals. This can include providing clinics with patient handouts on your clinic, education on what information is prioritized within the referral, and educating staff on how to complete their referrals effectively and efficiently. Social media can play an important role in referrals, especially for patients looking for cosmetic care. There are many different platforms, and these can serve as a marketing tool for physicians looking to bring in new patients.
Topics: Humans; Ambulatory Care Facilities; Referral and Consultation; Social Media
PubMed: 37718019
DOI: 10.1016/j.det.2023.06.001 -
British Dental Journal Nov 2019
Topics: Humans; Referral and Consultation
PubMed: 31705072
DOI: 10.1038/s41415-019-0951-x -
Circulation. Cardiovascular Quality and... Jan 2022
Topics: Cardiology; Humans; Referral and Consultation; Remote Consultation
PubMed: 35041485
DOI: 10.1161/CIRCOUTCOMES.121.008709 -
The American Journal of Medicine Jan 2021
Topics: Humans; Physicians; Referral and Consultation; Social Networking
PubMed: 32805231
DOI: 10.1016/j.amjmed.2020.07.018 -
The Journal of Pediatrics May 2022To examine characteristics of children referred for obesity management based on referral frequency, child- and referrer-related variables associated with re-referral,...
OBJECTIVES
To examine characteristics of children referred for obesity management based on referral frequency, child- and referrer-related variables associated with re-referral, and determine whether re-referral increased treatment initiation.
STUDY DESIGN
This population-level, retrospective analysis included all 2- to 17-year-olds referred for obesity management to 1 of 3 multidisciplinary clinics in Alberta, Canada between April 2013 and December 2017. Children were dichotomized based on referral frequency, specifically once only or more than once (re-referred). Data were retrieved from standardized referral forms and patient registries. Analyses included logistic regression and generalized estimating equations models.
RESULT
We analyzed data from 2745 children (47.2% female; mean age: 11.4 years; mean body mass index z score: 3.03) and 2705 physicians (60.2% female; 65.6% pediatricians). Overall, 300 (10.2%) children were re-referred with most (n = 276; 92.0%) being referred twice. Children were less likely to be re-referred if they were referred by a family physician (vs pediatrician) (aOR 0.62; 95% CI 0.46-0.84; P = .0018) or scheduled a clinic appointment following their index referral (aOR: 0.29; 95% CI 0.21-0.4; P < .001). Treatment initiation was higher in children who were referred once only (42.1%) vs their re-referred peers (18.0%; P < .0001); however, for children who were re-referred, they were more likely to initiate treatment following their second referral (aOR 2.3; 95% CI 1.22-4.31; P = .01). This improvement was not sustained on subsequent referrals (aOR 0.44; 95% CI 0.17-1.12; P = .08).
CONCLUSIONS
Few children were re-referred for pediatric obesity management; however, for those children who were re-referred, being re-referred once only increased the likelihood of treatment initiation.
Topics: Alberta; Body Mass Index; Child; Female; Humans; Male; Obesity Management; Referral and Consultation; Retrospective Studies
PubMed: 35074309
DOI: 10.1016/j.jpeds.2022.01.018 -
Journal of Neuro-ophthalmology : the... Dec 2020Neuro-ophthalmologists specialize in complex, urgent, vision- and life-threatening problems, diagnostic dilemmas, and management of complex work-ups. Access is currently...
BACKGROUND
Neuro-ophthalmologists specialize in complex, urgent, vision- and life-threatening problems, diagnostic dilemmas, and management of complex work-ups. Access is currently limited by the relatively small number of neuro-ophthalmologists, and consequently, patients may be affected by incorrect or delayed diagnosis. The objective of this study is to analyze referral patterns to neuro-ophthalmologists, characterize rates of misdiagnoses and delayed diagnoses in patients ultimately referred, and delineate outcomes after neuro-ophthalmologic evaluation.
METHODS
Retrospective chart review of 300 new patients seen over 45 randomly chosen days between June 2011 and June 2015 in one tertiary care neuro-ophthalmology clinic. Demographics, distance traveled, time between onset and neuro-ophthalmology consultation (NOC), time between appointment request and NOC, number and types of providers seen before referral, unnecessary tests before referral, referral diagnoses, final diagnoses, and impact of the NOC on outcome were collected.
RESULTS
Patients traveled a median of 36.5 miles (interquartile range [IQR]: 20-85). Median time from symptom onset was 210 days (IQR: 70-1,100). Median time from referral to NOC was 34 days (IQR: 7-86), with peaks at one week (urgent requests) and 13 weeks (routine requests). Median number of previous providers seen was 2 (IQR: 2-4; range:0-10), and 102 patients (34%) had seen multiple providers within the same specialty before referral. Patients were most commonly referred for NOC by ophthalmologists (41% of referrals). Eighty-one percent (242/300) of referrals to neuro-ophthalmology were appropriate referrals. Of the 300 patients referred, 247 (82%) were complex or very complex; 119 (40%) were misdiagnosed; 147 (49%) were at least partially misdiagnosed; and 22 (7%) had unknown diagnoses. Women were more likely to be at least partially misdiagnosed-108 of 188 (57%) vs 39 of 112 (35%) of men (P < 0.001). Mismanagement or delay in care occurred in 85 (28%), unnecessary tests in 56 (19%), unnecessary consultations in 64 (22%), and imaging misinterpretation in 16 (5%). Neuro-ophthalmologists played a major role in directing treatment, such as preserving vision, preventing life-threatening complications, or avoiding harmful treatment in 62 (21%) patients.
CONCLUSIONS
Most referrals to neuro-ophthalmologists are appropriate, but many are delayed. Misdiagnosis before referral is common. Neuro-ophthalmologists often prevent vision- and life-threatening complications.
Topics: Female; Humans; Male; Middle Aged; Neurology; Ophthalmology; Referral and Consultation; Retrospective Studies
PubMed: 31609835
DOI: 10.1097/WNO.0000000000000846 -
British Journal of Nursing (Mark Allen... Oct 2023, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the data indicating over-referrals to fitness-to-practise processes for certain...
, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the data indicating over-referrals to fitness-to-practise processes for certain groups.
Topics: Pregnancy; Humans; Female; Midwifery; Referral and Consultation
PubMed: 37830857
DOI: 10.12968/bjon.2023.32.18.911 -
The American Journal of Medicine Jan 2021
Topics: Ethics, Institutional; Humans; Quality of Health Care; Racism; Referral and Consultation
PubMed: 32810464
DOI: 10.1016/j.amjmed.2020.07.021 -
The Veterinary Record May 2021
Topics: Animals; Referral and Consultation; Remote Consultation; Telemedicine
PubMed: 33960448
DOI: 10.1002/vetr.485 -
Medicina (Kaunas, Lithuania) Oct 2019Despite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung... (Review)
Review
Despite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung transplantation. International guidelines for transplant referral and listing of patients with interstitial lung disease are not specific to those with IPF and were published before the widespread use of antifibrotic therapy. In this review, we discussed difficulties in decision-making when dealing with patients with IPF due to the wide variability in clinical course and life expectancy, as well as the acute deterioration associated with exacerbations. Indeed, the ideal timing for referral and listing for lung transplant remains challenging, and the acute deterioration might be influenced after transplant outcomes. Of note, patients with IPF are frequently affected by multimorbidity, thus a screening program for occurring conditions, such as coronary artery disease and pulmonary hypertension, before lung transplant listing is crucial to candidate selection, risk stratification, and optimal outcomes. Among several comorbidities, it is of extreme importance to highlight that the prevalence of lung cancer is increased amongst patients affected by IPF; therefore, candidates' surveillance is critical to avoid organ allocation to unsuitable patients. For all these reasons, early referral and close longitudinal follow-up for potential lung transplant candidates are widely encouraged.
Topics: Comorbidity; Humans; Idiopathic Pulmonary Fibrosis; Lung Transplantation; Referral and Consultation; Survival Analysis; Time Factors
PubMed: 31635104
DOI: 10.3390/medicina55100702