Annotated References Cowper DM, Lenton SW Letter writing to parents following paediatric outpatient consultation: a survey of parent and GP views Child Care Health Dev 1996;22:303–310 A survey of parents and general practitioners of pediatric outpatient clinic patients at a major teaching hospital in Bath, United Kingdom All 103 parents were in favor of receiving a letter from their child's specialist, and most general practitioners considered that the letters would improve parental satisfaction and compliance Cummins RO, Smith RW, Inui TS Communication failure in primary care JAMA 1980;243:1650– 1652 Survey of 233 referrals to specialists from a twophysician practice within 80 km of two university medical centers The overall rate of receiving follow-up information was 62% Private specialists provided more follow-up information (78%) than either universityaffiliated emergency rooms (48%) or universityaffiliated specialty clinics (59%) Curry RW, Crandall LA, Coggins WJ The referral process: a study of one method for improving communication between rural practitioners and consultants J Fam Pract 1980;10:287–291 Randomized prospective study of 235 patient referrals from three rural primary care clinics to a university medical center in Gainesville, Florida Receipt of specialist feedback occurred at a higher percentage (60%) when a mailer was included in the consultation request than with patient referrals in which a request for feedback and a return mailer was not included (39%) Private specialists were also more likely to provide feedback Epstein RM Communication between primary care physicians and consultants Arch Fam Med 1995;403–409 A frequently cited article that explores some of the core issues pertinent in problems of communication among physicians, including the different subcultures that have evolved among physicians providing primary care and specialists Case scenes highlighting the communication barriers are given Farquhar MC, Barclay SI, Earl H, et al Barriers to effective communication across the primary/secondary interface: examples for the ovarian cancer patient journey Eur J Cancer Care (Engl) 2005;14:359–366 This study explored the views of general practitioners regarding the process of communication from specialists in patients with ovarian cancer Nine general practitioners experienced in the care of patients with ovarian cancer from predominantly semirural regions in the United Kingdom participated in a structured interview process within 6 months of the death of their patient The main challenge of communication reported by the practitioners was the tardiness of the written or oral communication, which led to handcuffing of the general practitioners in their ability to provide appropriate care General practitioners reported inadequacies in their knowledge of test results and felt out of touch with the state of the patient Subsequent to the insufficient communication, the practitioners reported feeling inadequate in their ability to provide moral support, crisis management, patient advocacy, and end-of-life care Suggested communication improvements are reported in the text General practitioners as a group welcomed calls from doctors or nurses Forrest CB, Glade GB, Baker AE, et al Coordination of specialty referrals and physician satisfaction with referral care Arch Pediatr Adolesc Med 2000;154:499–506