Patient Referral or Appointment? Information Based, Patient Dependent Connections Between Primary and Secondary Care

Purpose: To monitor a new referral-appointment system for primary care physicians and patients. Context: Integration between the Turkish primary care and secondary care is deficient. There have been attempts of implementing a referral system and gate-keeping role for primary care physicians, both before Turkish Family Medicine Model and after the transition. Both obligatory and fee based referral systems were tried and all failed to put into practice but there are new affords for implementing a referral system. State of the art: Via a central appointment system a patient can schedule his/her appointment by using an online system or 182 call centre. Turkish patients can pick their own appointment date and can consult to any physicians they wish. Starting from June 2013 primary care physicians will have a new application to access this central appointment system, and will refer their patients to specialists. The Ministry of Health claims that this application will ease access to specialty care and empower primary care. The Turkish Association of Family Physicians, Family Medicine Centre Working Group will monitor this new implementation. Statements for debate: There are IT based solutions to increase communication between primary care and specialty care. The Turkish model seems the first of its kind and communication is primarily based on patient's dominance. We will monitor the physician’s point of view, both in primary care and secondary care. Does this implementation increase communication between physicians? We will look for best practice cases and discuss it within primary care groups for implementation in primary care.