What challenges arise in coordinating care across specialties?

Getting multiple specialists on the same page can be one of the trickiest parts of caring for patients. Between different doctors, treatment plans, and medical records, important details can easily slip through the cracks.

On Healthcasts, practitioners reveal the biggest challenges they encounter when coordinating care, and real-world solutions that have worked for them.

What challenges have you faced when working across specialties to make a care plan? Log in or sign up to read the full post, see the consensus, and provide your perspective. 

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Key takeaways about care coordination across specialties:   

• Communication gaps
  Coordinating multiple specialists is often hindered by poor communication. Providers may not have timely access to lab results, medication changes, or treatment plans, which can lead to conflicting recommendations and care delays.
  
• Fragmented Systems
  The lack of centralized records makes it hard to track patient history and keep all providers in the loop. Primary care physicians are sometimes left out of critical updates, and patients can feel lost navigating multiple systems.
  
• Follow-up shows you care
  Checking in after discharges or labs, walking patients to checkout, or offering telehealth options reinforces continuity and strengthens the provider-patient relationship.
  

Family Practice

"I would say it’s difficult to get everyone on the same page when trying to coordinate getting documentation from all the providers. A patient may not remember what medication was changed and then report the wrong information to the next specialist, causing conflicting treatment plans."

Family Practice

"Patients don't always seem to understand the reason they are being sent to the specialist. They come in and start discussing an issue that was not on the referral and was not mentioned in the referring practitioner's note."

Oncology/Hematology

"In my experience, the greatest difficulty arises with physician communication when multiple specialists are involved, each with their own diagnostic and therapeutic niches, and often each with a different idea of priorities in terms of how to proceed. Being the overarching coordinator in these situations can be difficult."

Pulmonology 

"Time, it seems that providers are stretched thin, and the number of patients per provider ratio has increased, making it more difficult to collaborate with others. Takes time and effort."

Oncology/Hematology

"I struggle with the timing of chemotherapy and radiation and coordinating it with surgery to get through treatment in the recommended period of time. There is an additional challenge in that we see patients from all over the state, and many receive their chemotherapy or external beam at outside institutions, and then we need to further coordinate our schedules between different cities/institutions.

Pediatrics

"I haven't thankfully dealt with as many issues in terms of communicating between the multiple providers, as we're connected through the same EMR and care system. However, scheduling and arranging to cluster appointments and care together to make it less burdensome for the patients and their families has been more difficult."

Family Practice

"Primary care physicians are often excluded from the loop even when we are the ones initiating the consultations. No one is clearly in charge, and the patient is shuffled from specialist to specialist without a decisive plan. Often the best thing to do is to educate the patient. I will often say something like, 'let’s touch base after you see the cardiologist. At that point, we can discuss the recommendations and decide together the best way forward.'"

Ophthalmology/Optometrists

"The hardest part is the lack of a central medical system across the health industry. Having a similar system to the VA network would be awesome to be able to see labs and specialist reports in order to coordinate care."

Infectious Disease/HIV

"Communication is number 1, 2, and 3. Unfortunately, it is difficult to have timely access to results and visits across disciplines, even in this era of health information exchange. There are still gaps in sharing these data. In my experience, patients can still be placed on medications by a provider who has serious interactions with medications prescribed by another due to a lack of sharing of information and communication."

Family Practice

"I have not worked in the hospital for 10 years, but it was in a very small rural critical access hospital. Of course, it was a lot easier then because we mostly consulted our phones and did everything ourselves. I do think it’s imperative to know your consultants well and consult early if there’s anything that’s not going according to plan."

Curious what other practitioners said was their biggest challenge with coordinating care across specialties? See all comments on the post and share your opinion on Healthcasts.