Hey, what happened to that referral?

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As many as one in three older Americans who are referred to a specialist never receive that appointment, according to a study published in the February issue of the Journal of Evaluation in Clinical Practice.

The study is a stunning example of the broken national healthcare system. One wouldn’t think it would be terribly difficult for a primary care doctor to connect his or her patient with a specialist. Apparently, that is not the case.

Researchers at Indiana University followed 6,785 primary care patients, ages 65 and older, at an urban medical center. Most of the patients were covered by Medicare. Only 71% of the patients referred to a specialist were scheduled for the appointment and only 70% of that group of patients actually went to the appointment. The visits fell through because of failure of the primary care doctor’s office to make the appointment, failure of the specialist’s office to receive the request for a consultation, failure to confirm the visit with the patient or problems on the patient’s end, such as the lack of transportation. I wonder how often referrals fall through because the appointments are made so far in the future that patients give up or forget?

The study is disturbing because people in this age group often need care from a specialist, and such care is likely to have a major effect on treatment and survival. It’s tough to know where to begin to fix problems such as these. But better communication systems among doctors’ practices would be a good start. Seems electronic health record-keeping can’t come soon enough.

-- Shari Roan