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Are You Up to Standard? Referral Consultation

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November Messenger 2020, Professionalism & Standards | Posted November 13, 2020

While times are trying for everyone, it’s important to remember the expectations of the Referral Consultation standard of practice to ensure compliance and help prevent your colleagues from being over-burdened.

Investigations are a joint responsibility

Clause 6 requires referring physicians to ensure they have evaluated and worked up the patient—including pertinent investigations—within their scope of practice. However, once a referral is accepted, the consultant becomes responsible for ordering additional investigations.

It is reasonable for consultants to request a referring provider to order specific investigations in advance of an appointment if it allows the patient to be seen sooner. Anything else regarding the appointment, such as identifying the time and date to the patient, is the responsibility of the consultant’s office.

Referrals from all healthcare providers must be considered

Clause 9 outlines the requirements of consultants to accept valid, thorough referrals from any healthcare provider. For example, it is inappropriate to refuse a referral simply because it comes from a nurse practitioner. When refusing a referral, you must provide reasons as well as suggestions for alternate care or consultation where possible.

Consultants are the most responsible physician

Once a referral has been accepted, the consultant is responsible for anything related to the patient’s care until the patient is formally discharged back to the referring provider. This includes:

  • Notifying the patient of their appointment date/time and fees not covered under AHCIP (clause 10(a));
  • Providing follow-up care to patients and confirming they are aware of further instructions (e.g., next appointment, prescription refills, etc.); and
  • Ensuring there is a process in place for the provision of continuous, after-hours care through appropriate healthcare providers and/or a service with capacity to assess and triage patient needs (per the Continuity of Care standard).

If you accepted a referral, it is inappropriate to direct the patient back to the referring physician for care arising from the consultation.


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