Comms Lab: Episode 39
Dealing With Referral Pushback: 5 Simple Strategies
As clinicians, we engage in negotiation every day – with our patients and with our colleagues.
Phone referrals, Consults, Admission Handoffs – whatever you want to call them – are one of the biggest communication challenges in medicine.
Referral pushback. It’s the bane of almost every hospital doctor’s working life, especially those who are early in their career, and especially those who have to make lots of referrals.
In this video, I share 5 tips for dealing with referral pushback, gleaned from the literature on conflict resolution, negotiation and my own experience.
Got feedback for me? Great! I’m always trying to make my videos better and more relevant. Let me know what you think in the comments section, or anonymously via jotform
0:00 – Pushback: for example..
0:48 – The Evidence
2:25 – 1. The Basic Assumption
3:18 – 2. Convert to F2F
4:28 – 3. Define the Disagreement
5:27 – 4. Gather (Don’t Give) Information
4:28 – 5. Try Empathy
5:27 – When it Doesn’t Work…
- Richards H. Mastering The Phone Referral: Comparing Structured Approaches. 2022
- Richards H. Mastering the Phone Referral: 5 Things You Must Understand BEFORE You Call. 2022
- Richards H. Dealing With Referral Pushback: 5 Simple Strategies. 2022
- Richards H. Graded Assertiveness: What’s the Best Approach? 2022
- Chan T, Orlich D, Kulasegaram K, Sherbino J. Understanding communication between emergency and consulting physicians: a qualitative study that describes and defines the essential elements of the emergency department consultation-referral process for the junior learner. CJEM. 2013 Jan;15(1):42-51. [PIQUED]
- Chan T, Sabir K, Sanhan S, Sherbino J. Understanding the impact of residents’ interpersonal relationships during emergency department referrals and consultations. J Grad Med Educ. 2013 Dec;5(4):576-81.
- Kessler C, Scott NL, Siedsma M, Jordan J, Beach C, Coletti CM. Interunit handoffs of patients and transfers of information: a survey of current practices. Ann Emerg Med. 2014 Oct;64(4):343-349.e5
- Lawrence S, Spencer LM, Sinnott M, Eley R. It Takes Two to Tango: Improving Patient Referrals from the Emergency Department to Inpatient Clinicians. Ochsner J. 2015 Summer;15(2):149-53
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Hayden is an emergency physician at University Hospital Geelong and a senior lecturer at Deakin University, Geelong. He is somewhat obsessed with the science and art of effective communication, and in particular: difficult conversations. He believes that we can all get better at having difficult conversations, and that the process of learning to do so can be seriously fun.
Hayden is also an avid but terrible surfer, ad hoc gardener, and dad to two awesome kids.