Parallel Surveys of Specialists and Family Physicians in Nova Scotia Regarding Satisfaction With the Referral Process


  • Blair A Williams
  • Peter AM Anderson



Background: The referral letter is fundamental to effective communication between family physicians (FPs) andspecialists. However, this document is frequently cited as a source of frustration for both referring and consultantphysicians.

Methods: Aspects of the referral process were identified and assembled in 2 surveys: one distributed to FPs and oneto specialists. The survey used a 5-point Likert scale for each aspect of the referral process. Surveys were mailed to500 family physicians and 500 specialists.

Results: There was a 42.4% and 43.8% response rate from FPs and specialists, respectively. Few of the survey itemsstood out as being particularly polarizing. There was no significant difference between FPs and specialists in thelevel of satisfaction, nor among the groups of specialists. Among FPs, those practicing outside of the Capital DistrictHealth Authority (CDHA) had significantly higher overall satisfaction than those practicing within the CDHA.

Conclusion: The results of the survey indicate that the referral letter could be improved by focusing on specificaspects of the letter. These points can be targeted at all levels of medical education (undergraduate, postgraduate,and continuing medical education) to help improve a process that is fundamental to our healthcare system. Thedisparity in overall satisfaction between FPs in CDHA and FPs in the rest of the province is intriguing given that CDHAhas the greatest number of specialists.