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J R Soc Med. 1990 April; 83(4): 241–244.
PMCID: PMC1292611

Psychiatric referrals within the hospital--the communication process.


This two part study examined the written communication between psychiatrists and other hospital doctors. In the first part a set of sample letters from a psychiatrist, who had seen a ward referral, was sent to 110 physicians and surgeons. Nearly half expressed a preference for a psychiatrist's letter that was one page long with main points underlined. Clarity of psychiatric diagnosis and opinion and clear treatment/follow-up arrangements were the key items of content. In the second part 100 consecutive referral letters and their replies were assessed; 20% of referral letters did not express the precise reason why psychiatric opinion was sought and many of the psychiatrists' replies did not describe adequately the follow-up arrangements and prognosis. In general the psychiatrist found the referral letters short and lacking in information whereas referring doctors found the brief replies from the psychiatrists preferable because the brief letters contained the key items mentioned in the first part of the study. In addition to these recommendations regarding written communications, this study emphasizes the need for personal discussion between psychiatrists and other hospital doctors; nearly half the doctors in the first part of the study thought this would be essential for good management of the patient.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Lee T, Pappius EM, Goldman L. Impact of inter-physician communication on the effectiveness of medical consultations. Am J Med. 1983 Jan;74(1):106–112. [PubMed]
  • Maruta T. Consultation psychiatry: communication with nonpsychiatric staff. Psychosomatics. 1979 Jun;20(6):418–419. [PubMed]
  • Williams P, Wallace BB. General practitioners and psychiatrists--do they communicate? Br Med J. 1974 Mar 16;1(5906):505–507. [PMC free article] [PubMed]
  • Pullen IM, Yellowless AJ. Is communication improving between general practitioners and psychiatrists? Br Med J (Clin Res Ed) 1985 Jan 5;290(6461):31–33. [PMC free article] [PubMed]
  • Yellowlees AJ, Pullen IM. Communication between psychiatrists and general practitioners. What sort of letters should psychiatrists write? Health Bull (Edinb) 1984 Nov;42(6):285–296. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press