A problem in the cooperation between primary and secondary healthcare is highlighted by the Cyprus Federation of Patient Associations (OSAK), with its president, Pampis Papadopoulos, conveying the concerns of personal doctors who participate in the organisation’s Scientific Advisory Committee.
As Mr Papadopoulos stated, while personal doctors are required to document the justification for every referral to a specialist, the feedback they receive is often limited or even non-existent. According to him, this complicates continuity of care and creates practical difficulties in managing patients.
The president of OSAK noted that, in daily practice, it is often observed that patients verbally convey instructions from specialist doctors to their personal doctors. Indicatively, patients inform their doctor that the specialist advised them “to repeat specific tests,” “to be reassessed in six months” or “to be referred again for a specific check-up,” without these instructions being adequately recorded in clinical notes.
As a result, according to Mr Papadopoulos, the personal doctor is forced to rely entirely on the patient’s description in order to make decisions regarding further management. The absence of substantial clinical documentation, he added, does not allow the personal doctor to know what the specialist’s findings were, what their reasoning was or what follow‑up or treatment plan is recommended.
According to OSAK, the issue is not procedural or bureaucratic, but directly linked to the quality and safety of care. When there is no clear and documented communication between specialist and personal doctor, the patient effectively becomes an intermediary between the two levels of care, with a risk of incomplete or inaccurate information being transferred.
The problem, as noted by Mr Papadopoulos, also affects continuity of monitoring, particularly in cases involving chronic patients or those requiring reassessment. Without comprehensive clinical notes, the personal doctor struggles to determine whether to renew treatment, request tests or refer the patient again to a specialist.
Restrictions burden the system
OSAK links this issue to broader distortions that, it argues, have emerged in the practical implementation of GESY. Mr Papadopoulos stated that, over time, restrictions imposed on personal doctors regarding prescriptions, referrals and diagnostic tests have increased, causing unnecessary movement within the system.
According to him, existing restrictions on prescribing certain medicines by personal doctors lead to referrals to specialists solely for prescription purposes, burdening waiting lists and delaying access for patients who genuinely need specialised care.
He cited as examples the inability to prescribe certain treatments for Chronic Obstructive Pulmonary Disease, as well as triptans for migraine, which, he argued, leads patients to pulmonologists and neurologists without always requiring specialised assessment.
OSAK is calling for the creation of evidence-based protocols instead of blanket restrictions, as well as a review of measures that, according to Mr Papadopoulos, inconvenience both patients and doctors and burden the system itself. As he stressed, the organisation is not seeking unchecked operation, but targeted revision of rules that no longer serve either the patient or the GESY system.
