SPECIALIST DOCTORS

All information in this publication refers to persons aged 45 years and over who had at least one general practitioner (GP) visit in the 12 months between November 2014 and November 2015.

Specialist doctors play a crucial role in the management and treatment of health conditions where they have specialist knowledge and skills. Examples of specialist doctors include dermatologists, cardiologists, neurologists and gynaecologists. Visits to specialist doctors require a referral from a GP or other doctors. Respondents were asked about the frequency of their visits, as well as the services they had used, waiting times, barriers to accessing care and their experience with the specialist doctors.

More than half of people (55%) saw a specialist doctor for their own health in the last 12 months. Of those who saw a specialist doctor, 26% went once, 50% went two to four times and 23% went five or more times.



It was more common for people aged 45 years and over to see two or more (51%) different specialist doctors in the last 12 months than to see only one (45%).

WAITING TIMES

Of those who saw a specialist doctor in the last 12 months, around one in five people (22%) reported waiting longer than they felt acceptable. This was more common for those aged 45 to 64 years (27%) than those aged 65 years and over (18%).

BARRIERS

Specialist doctors can have long wait times, high fees or be located far away, creating barriers to people accessing specialist care. There are a range of reasons why someone may not go to a specialist doctor when needed. Respondents in this survey were asked to select all reasons from a list, with the following choices: cost of appointment, no specialist doctor nearby, could not get an appointment when required, GP did not refer patient and other.

One in eight people (13%) indicated there was a time in the last 12 months when they felt they needed to see a specialist doctor but did not go. Those aged 45 to 64 years were twice as likely not to see a specialist doctor when they felt they needed to, compared with those aged 65 years and over (16% compared with 8%).

Nearly half (45%) of respondents indicated that the cost of the appointment was a reason they did not see a specialist doctor when they felt they needed to. Just over one quarter (28%) indicated that they could not get an appointment when required and one in eight (12%) stated there was no specialist doctor nearby.

Those aged 45 to 64 years were more likely not to see a specialist doctor when they felt they needed to due to cost of appointment than those aged 65 years and over (49% compared with 32%). More women than men indicated the cost of an appointment as a reason for not seeing a specialist doctor when they felt they needed to (49% compared with 39%).



A similar proportion of people aged 45 to 64 years (29%) and 65 years and over (27%) indicated they did not see a specialist doctor when they felt they needed to because they could not get an appointment when required.

EXPERIENCE WITH SPECIALIST DOCTORS

All respondents who saw a specialist doctor in the last 12 months were asked about their experience with specialist doctors. The majority (87%) of people reported that their specialist doctor always had their medical information or test results, while 8% stated there was at least one time when their specialist doctor did not have their medical information or test results. A further 4% indicated that they did not know whether their specialist doctor had their medical information or test results. Almost all (95%) reported that their specialist doctor explained treatment choices so that they could be understood.

Increasing patient involvement is an important part of quality improvement, as it has been associated with improved health outcomes¹. Nearly nine in ten people (89%) indicated that their specialist doctor always or usually involved them in decisions about their own health care in the last 12 months.

SPECIALIST DOCTORS AND USUAL GP OR USUAL PLACE OF CARE

Communication and information sharing between specialist doctors and a patient's usual GP or usual place of care can result in benefits for the patient². Those who saw a specialist doctor were asked whether their usual GP or others in their usual place of care seemed informed about the care they received from the specialist doctor:

• 76% stated that their usual GP or others in their usual place of care seemed informed
• 6% stated that their usual GP or others in their usual place of care did not seem informed
• 3% stated that their usual GP or others in their usual place of care did not know about specialist care until the patient informed them
• 9% did not know if their GP seemed informed and
• 5% did not go to their usual GP or usual place of care after their specialist doctor visit (or had not yet gone to their usual GP or usual place of care after their specialist doctor visit).

It was more common for those aged 65 years and over than those aged 45 to 64 years to report that a usual GP or others in their usual place of care seemed informed about the care they received from a specialist doctor (84% compared with 68%). People aged 45 to 64 years were more likely to indicate they did not to know if their usual GP or others in their usual place of care seemed informed about the care they received from the specialist doctor (11% compared with 6%).

1 Longtin Y, Sax H, Leape L, Sheridan S, Donaldson L, & Pittet D 2010. Patient participation: current knowledge and applicability to patient safety. Mayo Clinic Proceedings 85(1): 53–62.

2 Sampson R, Barbour R, & Wilson P 2016. The relationship between GPs and hospital consultants and the implications for patient care: a qualitative study. BMC Family Practice 17(45).