Communication between primary care physicians (PCPs) and hospitalists occurs only 3–20% of the time. The aim of this study is to assess the PCPs’ response to information requests at the time of their patients’ hospital admission.
Seventy–six patients admitted to the internal medicine service of an academic medical center whose PCP’s were outside our EMR system and whose information was no so urgent that it required an immediate phone call. The attending physician on service completed a request form at the time of a patient’s hospital admission. The PCP was identified by the patient’s information face sheet or from the patient themselves. Seventy–six forms were faxed to the PCP within 24 h of the patients’ admission. Confirmation of FAX receipt was obtained from secretarial phone contact with the PCP’s office. The total number of responses, the timing of response, and the response to each category: Medications, Problems, Allergies, Vaccinations, Code Status, Date of Last Visit, and Response to a specific inquiry were tabulated, and percentage of response was calculated.
Seventy–six faxes were sent to PCPs. Forty (53%) PCPs responded. Seven responses were excluded, because the patient was no longer the PCP’s patient. Of the remaining 33 responders, 16 (55%) replied the same day, 9 (31%) replied within one day, and 4 (14%) replied 2 days or later. Items Completed on the PCP’s Returned Faxcimilies: Medicine List 26/29 (90%), Problem List 25/29 (86%), Allergy List 19/29 (66%), Vaccination record 20/29 (69%), Code Status 4/29 (14%), Date of Last Visit 20/29 (69%), and Response to specific inquiry 8/11 (73%).
Nearly half of PCPs did not respond to faxed inquiry. Medication and problem lists where the best response, 90% and 86%, respectively. The worst was documentation of code status, which was markedly low at 14%. If a PCP responds, they do so quickly in 1–2 days. We propose that hospitalists be accountable for informing the PCPs of patient admissions, and PCPs be accountable for communicating complete information to the hospitalist, whether it be by an EMR or a simple fax.