The need for clear communication in medicine is often stressed, but of all aspects of medical communication probably the least attention is given to that between doctors themselves. The structure of the NHS and the mode of referral from general practitioners (GPs) to specialists mean that the quality of communication between GP and specialist has a strong influence on the way patients are managed and the standard of the care provided. Although it might seem preferable that contact between doctors should be on a face to face basis, this is often not possible. By far the most common mode of communication between GP and specialist is the letter.
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