Modern health care faces many challenges, including effective management of patient referrals. Many experts, especially those in hematology, have noticed the increase in unnecessary referrals, a trend that raises questions about the status of healthcare practices. In the complex landscape of modern healthcare, the trend of unnecessarily referring experts is attracting attention and attention.
In a recent study by Benjamin Djulbegovic and Charles Greenberg, PhD, of the Department of Medical Hematology and Oncology at South Carolina Medical University, this phenomenon highlights medical care Systemic problems in health care practice. Their comments, published in the journal Blood Progress, were critically examined on this referral model and its impact on patient care.
The study proposes several case vignettes that reflect the problem. A noteworthy example is a 91-year-old man who traveled for three hours to make an appointment with a hematologist to seek advice on anticoagulation, a decision that could be made by consulting existing guidelines. Similarly, a young woman was referred for a potential diagnosis of hematologic cancer due to anemia and platelet disease, which is often associated with iron deficiency and can be corrected with appropriate treatment.
These examples reflect a broader trend in healthcare where patients are often referred to specialists to be managed by primary care physicians or easily accessible information. This model leads to what the author calls “overfragmentation” of health care – providing services among a large number of undercoordinated providers. As a result, patients often endure long waiting times and undergo unnecessary procedures, resulting in inefficiency and increased medical expenses.
“The lack of time is increasingly undermining clinical judgment, leading to unnecessary referrals and split care,” explains Dr. Djulbegovic. This situation exacerbates the situation as doctors want to see more patients’ financial stress , thereby further reducing the time available to everyone.
Dr. Djulbegovic State highlighted that “the increasing number of specialists are not only our specialized hematology, not only our specialized hematology trends, not only our specialized hematology trends.” They propose potential solutions to solve this growing problem. One such solution is to increase the use of electronic consultations that allow quick access to professional advice and current guidelines, thereby reducing unnecessary referrals by more than half. They also highlighted that the healthcare system motivates providers to spend more time developing their capabilities, thereby reducing the need for care splits.
In conclusion, this question highlights a key challenge in a healthcare system where quality of care compromises manageable conditions due to overuse expert recommendations. The study calls for a reassessment of current practices, urging a more effective, patient-centered approach to health care.
Journal Reference
Djulbegovic, B., Greenberg, CS (2023). Hematology referral mad syndrome. Blood Progression, 7 (21), 6702. doi: https://doi.org/10.1182/bloodadvances.2023011434.
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About the Author
Benjamin Djulbegovic, MD, PhD is a professor at South Carolina Medical University, South Carolina and director of the Classical Hematology and Hematology Management Program at the South Carolina Medical Oncology and Hematology Department. His main academic and research interests are trying to measure and optimize the clinical research and practice of medicine by understanding the nature of medical evidence and decision-making. To this end, his work aims to end the translational research circle by integrating inter-evidence-based medicine (EBM) approaches and technologies, predictive analytics, health outcomes research and decision-making science to reduce overuse, non-use and misuse of delivery of health Services to improve patient health outcomes.
Dr. Charles Greenberg is a professor of medicine at South Carolina Medical University, in the Classical Hematology section of the Department of Hematology Oncology. His main academic interests focus on hemostasis and thrombosis. His clinical practice uses telemedicine to serve patients in SC. His main basic scientific interest is the structure of plasma and tissue transglutaminase. During his career, he has been involved in the evaluation of new clinical laboratory tests to help manage patients with hemostasis or thrombotic problems. His academic work has been focusing on directing basic and clinical laboratories to patients.
