A 42-year-old multiparous patient presented for consultation as a referral for management of recurrent catamenial pneumothorax. Evaluation by a pulmonologist failed to reveal any chest masses. She was treated for endometriosis using Danazol 800 mg daily for 6 months. Pneumothorax did not recur during treatment and during follow-up visits.

BACKGROUND A broad case-mix in family physicians' (general practitioners', GPs') vocational trainee experience is deemed essential in producing competent independent practitioners. It is suggested that the patient-mix should include common and significant conditions and be similar to that of established GPs. But the content of contemporary GP trainees' clinical experience in training is not wel...

Background: The referral letter is an often-overlooked yet essential element that contributes to the quality of patient care when specialist services are accessed. In the field of maternal-fetal medicine, incomplete referral letters that fail to comprehensively identify pregnancy risk factors can have significant implications for pregnancy management and delivery planning. Objectives: To evalua...

In 1983-84 general practitioners in the Oxford region kept records of their referrals to outpatient clinics over a period of six months. Five years later in 1988-89 the general practice notes of 182 patients referred for back pain were studied to determine the outcomes of their referral. The actions initiated in the outpatient clinics were compared with the general practitioners' main reason fo...

BACKGROUND Access to specialty care remains a challenge for primary care providers and patients. Implementation of electronic referral and/or consultation (eCR) systems provides an opportunity for innovations in the delivery of specialty care. We conducted key informant interviews to identify drivers, facilitators, barriers and evaluation metrics of diverse eCR systems to inform widespread impl...

OBJECTIVE To assess the concerns of adult patients with spine-related complaints during the period between referral to and consultation with a spine surgeon. DESIGN Prospective survey. SETTING Toronto, Ont. PARTICIPANTS A total of 338 consecutive, nonemergent patients before consultation with a single spine surgeon over a 5-month period. MAIN OUTCOME MEASURES Patient concerns, effect of...

BACKGROUND Much has been written about the patient-centred approach in doctor-patient consultations. Little is known about interactions and communication processes regarding healthcare providers' and patients' perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to th...

Background: Lung cancer is associated with rapid disease progression, which can significantly progress over a duration of four to eight weeks. This study examines the time interval lung cancer patients from the interior of British Columbia (BC) experience while undergoing diagnostic evaluation, biopsy, staging, and preparation for treatment. Methods: A chart review of lung cancer patients (n=23...

Rheumatologists in the former South West Regional Health Authority (SWRHA) have undertaken regional audits of their out-patient workloads on five occasions from 1988 w1x to 1994 w2x. These spanned the introduction of the NHS reforms of 1991 w3x, for which proper evaluation was not undertaken either before or during their introduction. The rheumatology audits recorded all out-patient referrals d...

PURPOSE Patient preferences for radiation therapy (rt) access were investigated. METHODS Patients completing a course of rt at 6 centres received a 17-item survey that rated preferences for time of day; day of week; actual, ideal, and reasonable travel times for rt; and actual, ideal, and reasonable times between referral and first oncologic consultation. Patients receiving single-fraction rt...