REFERAL LETTER

Read the following letters. Which letter is good and which letter is not
good? Why?

1. Ms AB’s doctor has referred her to a gastroenterologist.

Dear Gastroenterologist,
Thank you for seeing Ms AB a 45-year-old female with GERD.
Kind Regards, Dr AH

2. Mrs. Davis’s doctor has referred her to an endocrinologist.

Dear Doctor,
I would be grateful if you would see this 50-year-old woman who has lost 20 kilos
in weight in spite of eating more than usual. She describes herself as overactive
and at first she thought the weight loss was due to this. But more recently she has
developed palpitations, diarrhea, and heat intolerance. She has noticed that her
hands have a tendency to shake.
Her symptoms suggested hyperthyroidism and this was confirmed by my
examination which revealed an enlarged thyroid, red sweaty palms and a fine
tremor of the hands.
Thank you for seeing him.
Yours faithfully,
Mary Knox
3. Ms AB’s doctor has referred her to a gastroenterologist.
21/9/2020
Dr. Silver Bullet
Prospect Medical Center
22 Prospect Road
Prospect 5086
Dear Dr. Bullet,
Re: Julia Roberts, D.O.B: 18/5/1975

Thank you for seeing Ms. Roberts a 45-year-old female with difficulty to control
gastro-oesophageal reflux disease for your consideration of a gastroscopy.
She has had 6 months of worsening epigastric pain, worse after meals. She has
not displayed any constitutional symptoms during this time. Her medical history
includes obesity and a cholecystectomy in 2016. She is currently on 40mg
esomeprazole daily and doesn’t have any allergies.

The only finding on physical examination is epigastric tenderness on palpation of

her abdomen. Her most recent liver function tests (dated 1/3/2020) and upper
abdominal ultrasound (dated 1/2/2020) were normal. A H. Pylori breath test
(dated 1/3/2020) was negative. For the past 6 months she has been managed with
40mg esomeprazole daily. She has also modified her diet and been trying to lose
weight.

Despite this her symptoms persist and I would greatly appreciate your clinical
review and consideration of a gastroscopy to confirm this diagnosis and ensure no
other pathology contributing to her symptoms.

Kind Regards,
Dr. AH
Sydney Primary Practice Sydney, NSW 2000
PRACTICE
1. Based on the notes, write a referral letter to a cardiologist for this patient.
SURNAME Green FIRST NAMES Peter
AGE 42 SEX M MARITAL STATUS M
OCCUPATION Salesman
PRESENT COMPLAINT
Central chest pain radiating to L arm. Started with severe attack c. dyspnea. Pain
lasted 10 mins relieved by rest. Has occurred since on exertion.
O/E
General Condition
ENT
RS Chest clear/ normal
CVS P(pulse) 70/min
BP (blood pressure) 130/80
HS (heart sounds) normal

Date ____________
Dear______________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________