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Generalist physicians’ challenges in understanding specialists’ clinic notes
  1. Bryan S Lee1,2,
  2. Jared W Klein3,
  3. Natalia V Oster3,
  4. Joann G Elmore3
  1. 1 Altos Eye Physicians, Los Altos, California, USA
  2. 2 Department of Ophthalmology, University of Washington, Seattle, Washington, USA
  3. 3 Department of Medicine, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Joann G Elmore, Department of Medicine, University of Washington, Harborview Medical Center, 325 9th Ave, Box 359780, Seattle, WA 98104, USA; jelmore{at}, jeadmin{at}

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Millions of patients now have online access to their full electronic medical record, including the clinic notes from general and specialty physicians.1–4 At our institution, all clinic notes have been accessible to patients via a secure patient portal since October 2014,5 Subsequently, some patients are now asking their generalist physicians to answer questions about subspecialists’ clinic notes.

We conducted the first known survey to assess general physicians’ self-assessed understanding of specialty ophthalmology clinic notes. While general physicians’ understanding of patients’ eye care issues has substantial clinical relevance, we hypothesised that eye clinic notes might be challenging for primary care providers to understand.

We administered a print survey to internal medicine interns, residents, fellows and attending physicians at the University of Washington. Participants were recruited at a grand rounds presentation and an outpatient clinic.

The survey included three questions about engagement with and understanding of ophthalmology notes and two questions self-rating their understanding of sample ophthalmology clinic notes.

Of the 59 responding physicians, the majority reported trying to …

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