Clarification of Elevated Liver Values – How do Gastroenterological Specialists Experience Cooperation with Family practitioners?

DOI: 10.3238/zfa.2018.0494-0499

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Michael Jansky, Julian Wangler, Marc Nguyen-Tat, Anita Arslanow, Peter R. Galle

Keywords: diagnosis and treatment pathway early detection family practitioner liver transaminases

Background: In outpatient care, elevated liver enzymes are a frequent incidental finding. For effective diagnosis, it is important which liver values are taken into account in which constellations as indicators, at which point patients are referred for further diagnostics, and to what extent there is an effective cooperation between primary and secondary care settings. The main focus of this paper is on the challenges of cooperation between family practitioners and gastroenterological specialists in clarifying (unclear) elevated liver enzymes.Methods: In the spring of 2018, a survey of community gastroenterologists (N = 54) took place in Rhineland-Palatinate and Saarland. The article focuses on selected results regarding the cooperation between family practitioners and these specialists.Results: The cooperation between primary and secondary care level is characterized by challenges. Specialists criticize medical workup and diagnostics carried out by family practitioners and the time of referral. In addition, a vast majority consider the introduction of a structured diagnostic algorithm as an important approach to improving early detection and achieving better coordination between different levels of care.Conclusions: The survey revealed interface problems between family practitioners and specialists. A diagnostic pathway for classifying and evaluating elevated liver enzymes can be a valuable tool that can effectively support family practitioners in diagnosing and better structuring collaboration with specialists.

(State: 14.12.2018)

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