Summary
In a subspecialty interdisciplinary voice and swallowing clinic, patient referrals
come from a wide variety of disciplines for various reasons, which can make scheduling
their initial evaluations challenging. Depending on the nature of complaints and symptoms,
patients may best be evaluated either by a single provider (a laryngologist) or by
an interdisciplinary team that includes a speech-language pathologist. If not scheduled
appropriately, the provider and the patient may lose valuable time, resources, and
money. This was a retrospective chart review of 76 patients who received an interdisciplinary
evaluation in our Voice and Swallowing Center‘s first 7 months of operation. Two factors
were examined for their predictive values: the most common reasons for referral and
the disciplines that commonly refer to the clinic. The goal was to probe for any variables
known at the time of referral that could inform us whether an interdisciplinary evaluation
would be beneficial or not. This information informs resource planning for space,
equipment, scheduling, and staffing. The results showed that the most common reasons
for a referral to the Voice and Swallowing Center were dysphonia (34.8%), dyspnea/paradoxical
vocal fold motion (“PVFM,” 20.2%), and dysphagia (18%). Statistical analysis of the
results indicated that certain reasons for referral were more likely to require an
interdisciplinary evaluation than others: dysphonia, irritable larynx syndrome/chronic
cough, and PVFM. Referrals most commonly came from providers with a background discipline
of primary care (26%) and otolaryngology (22%). The discipline of a referring provider
alone was not a strong enough indicator to reliably predict the type of evaluation
needed. Examining the available data on referral patterns, as this study has done,
has the potential to inform providers how to better anticipate their patients’ needs
and also improve clinic operations.
Key Words
Abbreviations:
ID (interdisciplinary), UVA (University of Virginia), PCP (primary care physician), PVFM (paradoxical vocal fold motion), ILS (irritable larynx syndrome), VCD (vocal cord dysfunction)To read this article in full you will need to make a payment
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References
- What do we know about health care team effectiveness? A review of the literature.Med Care Res Rev. 2006; 63: 263-300
- Interdisciplinary versus multidisciplinary care teams: do we understand the difference?.Austr Health Rev. 2007; 31: 330
- The interdisciplinary team in geriatric care.Am Behav Sci. 1996; 39: 655-664
- Vocal fold scarring: current concepts and management.Otolaryngol Head Neck Surg. 1996; 115: 474-482
- Interventions to Improve Outpatient Referrals From Primary Care to Secondary Care, The Cochrane Library,. 2008;
- Resolving the gatekeeper conundrum: what patients value in primary care and referrals to specialists.JAMA. 1999; 282: 261-266
- Factors influencing referral of patients with voice disorders from primary care to otolaryngology.Laryngoscope. 2014; 124: 214-220
- Primary care approach to dysphonia.Otolaryngol—Head Neck Surg. 2010; 142: 310-314
- Survey of primary care physicians' approach to gastroesophageal reflux disease in elderly patients.J Gerontol A Biol Sci Med Sci. 2001; 56: M514-M517
- Perceptions and practices on the management of gastro-oesophageal reflux disease: results of a national survey comparing primary care physicians and gastroenterologists.Aliment Pharmacol Ther. 2007; 25: 823-833
- Can we improve dysphagia referrals?.J Laryngol Otol. 2007; 121: 584-587
- The prevalence of dysphagia in primary care patients: a HamesNet Research Network study.J Am Board Fam Med. 2007; 20: 144-150
- Direct health care costs of laryngeal diseases and disorders.Laryngoscope. 2012; 122: 1582-1588
Article info
Publication history
Published online: November 03, 2018
Accepted:
October 9,
2018
Footnotes
No conflicts of interest to disclose.
No financial interests to disclose.
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.