I agree that they might not be appropriate for a formal consultant's letter although more and more, I tend to simply receive the consultant's office note as my "letter". This is fine with me and actually I get more information this way many times than I do with a conventional letter. For instance, many times I will get a formal letter which might say (got this one today) "I explained to the patient that we could perform a knee replacement if they feel their symptoms warrant it" but the patient heard "I do not think surgery is indicated at this time based on your symptoms". Big difference. The patient told me they could not go on like they are now and that they were ready for replacement. I sent the patient back to the consultant.

I also fax my notes on most occasions TO consultants (oncologists, cardiologists, gastroenterologists) who are also seeing patients regularly and who many times require routine or follow-up labs. If my note reflects the fact that I am already sending the patient for tests, hopefully the consultant will not send them also for the same things. Patients most of the time don't know what labs they are having done. I may see a patient the day after or the day before, say, the oncologist and they do not know what labs were drawn. It may take several days for me to receive the formal consultant's letter but a faxed note is there immediately. I know this topic is not on the validity of consultants notes but, I do believe that my notes, particularly when they include the instructions for the patient as well as the planned labs and tests, more accurately reflect what we actually plan to do than might a letter about my visit with the patient. Just my opinion.

Leslie

Leslie
Hospital Employed Physician Who Misses The Old AC

"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "