Family medicine practices are the “home” for most of our patients' health care needs. Sometimes, of course, our patients need the expertise of more specialized physicians, which means sending our patients out into the wider “medical neighborhood.” This journey can be risky because of the lack of coordination among the fragmented medical team. This often results in duplicative tests, unnecessary treatments, and conflicting recommendations between one physician and another.
As our patients' family physicians, it is our responsibility to ensure that they have coordinated care when we provide referrals so that they receive efficient, high-quality medical treatment and seamless transitions of care. This is an important role for family physicians, whether we practice in a free-standing primary care group referring to the consultants across town, as I do, or as part of a large health care organization referring to the consultants down the hall. The issues that occur between family physicians and consultants are largely the same.
For the past 10 years, our practice has used service agreements to facilitate the complex relationships between family physicians and consultants. A service agreement is a written document — not a contract — negotiated between the primary care practice and an individual consulting specialty practice that defines the expectations of referrals between the two offices and clarifies common issues such as urgent access to the consultant and timely exchange of information. This article will discuss why these agreements are helpful and how to develop them for your practice.
