Table 4 Challenges experienced in the interdisciplinary relationship, gastroenterological specialists. Question: A variety of challenges may arise when gastroenterologists and general practitioners work together to diagnose and treat cirrhosis. How often have you experienced the following challenges? (N = 313, gastroenterological specialists)

I have detected (incipient) liver disease that the general practitioner did not notice or remained unaware of in a patient.

25%

59%

11%

4%

1%

Primary care could do better at initial testing and diagnosis of (incipient) liver disease.

29%

42%

17%

10%

2%

General practitioners are not always sufficiently aware of elevated liver values with unknown aetiology to notice the onset of liver disease at an early stage.

27%

43%

13%

13%

4%

Patients that general practitioners have referred to gastroenterologists for an elevated liver count of unknown aetiology often turn out to be non-specific.

18%

51%

15%

12%

4%

General practitioners often fail to follow up on elevated liver values.

23%

42%

17%

15%

3%

General practitioners are too quick to refer patients with elevated liver values of unknown aetiology to gastroenterologists, leaving gastroenterologists booked out for long periods of time.

34%

30%

19%

14%

3%

General practitioners do not adequately inform gastroenterologists about the tests they perform, the results and/or the diagnoses they have made.

20%

43%

20%

16%

1%

General practitioners are inconsistent in their approach to analysing liver values; this may include varying liver values recorded depending on the general practitioner, so specialists need to keep adjusting to the preliminary work performed by general practitioners.

35%

22%

22%

20%

1%

General practitioners wait too long before referring patients with an elevated liver count of unknown aetiology to a gastroenterologist.

30%

27%

25%

16%

2%