Increasing Correspondence in a Rural Surgery


Seeing patients face to face is only one aspect of general medical practice. Behind the scenes, we have to write referral letters and read correspondence coming back from hospital.

Because I was feeling that the volume of correspondence was increasing, I asked our data entry clerk to search our computer records for records of letters sent and received by the practice.

We are fully computerised, and the data is reliable.

The chart below shows the results of a search on correspondence activity between 1997 and 2003.

(c) Richard Lawson 2004

There is a significant increase in activity in the 6 year period. The trendline shows a 30% increase in incoming, and 60% increase in outgoing mail.

There are probably several reasons for this increased activity, but I suspect that it reflects raised standards of clinical governance, and a need to work to protocols and guidelines. We will order investigations like endoscopies (putting inspection tubes into holes to look around inside) routinely nowadays in order to be sure that there is no possibility of cancer, in cases where years ago we would have simply prescribed an antacid. This is good for the tiny proportion of cases where a cancer is found earlier than in days gone by, but it represents a huge amount of increased effort - not to mention discomfort for the vast majority of patients where cancer is not found.

The bottom line is that it is all very well for the government to require us to work to higher standards, but the amount of time and energy available to doctors is finite, and it cannot be expected that we can safely increase our activity year on year indefinitely.


Richard Lawson 30.10.2004

© 2001 R. Lawson This page was last updated on 13.11.04