The GP-hospital interface: attitudes of general practitioners to tertiary teaching hospitals

Abstract

Objective: To assess general practitioner (GP) perceptions of liaison with two local tertiary teaching hospitals.

Design: Questionnaire-based survey of GP attitudes.

Setting: Melbourne and North West Melbourne Divisions of General Practice, in July and September 1994.

Participants: All GPs (587) practising in the Divisions (identified from Health Insurance Commission lists of consultations charged at GP rates).

Outcome measures: Degree of agreement on a 5-point Likert scale to statements about GP-hospital liaison, and relevant open comments.

Results: 350 GPs (60%) responded, including 84% of vocationally registered GPs; 68% of the 350 were in full-time practice and 70% had been in practice for over 10 years. GPs had no clear strategy for obtaining admission of semi-urgent patients to public hospitals. For patients needing urgent admission, almost a third of GPs sometimes resorted to sending them to the emergency department without first telephoning. Most GPs agreed that hospitals did not notify them of patient admission (84%), major changes in patient condition, including death (87%), and patient discharge (75%). Most would interrupt a consultation to discuss a patient with hospital staff (92%). About half agreed they had poor access to outstanding results, and 65% were concerned that proposed early-discharge practices would be detrimental to patient care.

Conclusions: The survey identified considerable GP dissatisfaction with hospital-GP communication and GP willingness to be more involved in liaison and communication with hospitals about patient care. Changes in hospital organisation and hospital staff attitudes are needed to allow this.