10 top tips for writing an outpatient clinic letter
In this article we will go through our 10 top tips for writing a good outpatient clinic letter.
Writing a good outpatient letter is a skill that you are not taught at medical school. Do you want to improve your outpatient clinic letters? This is how to do it.
1. Be clear on why you are writing the letter
These are the 4 reasons for a letter (especially the ‘3 C’s: ‘communication, communication and communication’):
- Communication with GP (or other health professionals) – to encourage action they need to take
- Communication with patient – to encourage action they need to take. Copy or write letters directly to the patient whenever possible
- Communication with hospital colleagues – in other departments, or if the patient comes in as an emergency
- Medicolegal record – i.e. a record of the assessment.
2. Start well – with a summary, with clear headings
It should include a diagnosis, up-to-date drug list (or absent if not sure); and an ‘action for GP (and/or other colleagues)’ area that is clear, at the bottom of the summary section, which is near the top of the letter. This is a good 5 item structure:
- Syndrome
- Diagnosis
- Other diagnoses
- Medication / allergies
- Action for GP (and/or other colleague).
3. Action for GP (and/or other colleague)
This should be last in the summary at the top, so it is easy for a GP to find and enact.
4. Provide a clear treatment plan
This should include useful information for the patient, and a handover of care to next health professional. Phrases like ‘please consider X’ etc are not helpful.
5. Keep the letter brief, clear, readable and relevant
Less is more. Avoid different types of emphasis – e.g. CAPITALS (shouting!), bold and italics.
6. Use letters to record explanations of risk vs benefit and consent
Make risk vs benefit analysis clear (especially if consent is required for an investigation, procedure or operation); and state what is opinion, not based on evidence, and therefore up for debate (including the patient and GPs opinion).
7. Finish well – with a clear follow-up plan
This should include next steps, with your contact details.
8. Write or dictate letter
How is that going to happen quickly and efficiently with least mistakes?
9. Copy to other health professionals if necessary
Who does letter need to be copied to? Think about why you are doing that? Is it necessary? Do they need a covering note, asking them a specific question? Do not copy colleagues in for the sake of it, just because you think they ‘might be interested’.
10. Ask yourself is additional communication needed?
If the information so important, it needs to be backed up with a handwritten note to their GP (for patient or family to take to them), an email or a phone call, or combination? If that is so, keep a record of it.
What is a good outpatient letter?
One that has achieved all these objectives, and the subsequent action (if requested in the letter) has happened.
Notes
(1) Most mistakes in medicine are due to poor communication (or poor observation of the patient, or poor prescribing). Good letters can prevent all three
(2) Explaining the pros and cons of a plan, and obtaining consent, is often best done in an outpatient clinic – where there is more time and things are calmer (than on the ward, or on the day).
Summary
We have described 10 top tips for writing an outpatient clinic letter. We hope it has helped you.
Other resource
There is more information here on the Royal College of Radiology (RCR) website.
