2.3 Initial referral
The patient’s general practitioner should refer the patient to a specialist (with expertise in lung cancer, who is affiliated with a multidisciplinary team) for treatment if the diagnosis is confirmed or to make the diagnosis if the diagnosis is not conclusive (Cancer Australia 2020b).
See Lung Foundation Australia’s, ‘Lung Cancer Multidisciplinary Team’ directory for institutions that have multidisciplinary teams with expertise in lung cancer.
Patients should be enabled to make informed decisions about their choice of specialist and health service. General practitioners should make referrals in consultation with the patient after considering the clinical care needed, cost implications (see referral options and informed financial consent), waiting periods, location and facilities, including discussing the patient’s preference for health care through the public or the private system.
Patients in some rural or remote locations may access specialists via telehealth services. General practitioners working in remote or rural locations should be aware of such facilities before referral.
Referral for suspected or diagnosed lung cancer should include the following essential information to accurately triage and categorise the level of clinical urgency:
- important psychosocial history and relevant medical history
- family history, current symptoms, medications and allergies
- results of current clinical investigations (imaging and pathology reports)
- results of all prior relevant investigations
- notification if an interpreter service is required.
Many services will reject incomplete referrals, so it is important that referrals comply with all relevant health service criteria.
If access is via online referral, a lack of a hard copy should not delay referral.
The specialist should provide timely communication to the general practitioner about the consultation and should notify the general practitioner if the patient does not attend appointments.
Aboriginal and Torres Strait Islander patients will need a culturally appropriate referral. To view the optimal care pathway for Aboriginal and Torres Strait Islander people and the corresponding quick reference guide, visit the Cancer Australia website. Download the consumer resource – Checking for cancer and Cancer from the Cancer Australia website.
The first specialist appointment should take place within two weeks of the initial general practitioner referral.