Docs don't necessarily communicate directly. What I've observed is that after I've seen a specialist a report is (supposed to be) sent to my GP, then it goes in my chart. This may be a stack of papers or electronically in the doc's office. Generally my doc does not actually see what has transpired until just before I see him, the GP, when he peruses my file for a few seconds before seeing him face to face. That way he can walk in and sound like he knows what's going on.
So while doc has all this stuff going on, including having just come from a similar yet totally different confrontation with the patient just before, he may or may not remember anything that was said on your previous visit. Sometimes you may need to give him the 30 second rundown (if doc is the type that allows you to speak).
Now this entire process just completely falls apart if the specialist's office staff failed to forward a copy of the report to your GP, or to the referring physician. It happens more often than you would like to think. We believe they are all well organized and efficient. The office staff is constantly distracted by phone calls and incidental requests. They set down a piece of paper or have to look something up on the computer, then lose track of what they were working on. Your report gets filed without ever being forwarded. It happens. Sad, but I have also been bitten by this on many occasions.
By the way, I would like to re-emphasize what John_TX said a few posts above. My wife is also a BSN with 40 years of hospital experience and would come home and vent about
all the stuff that happened. We had first met shortly after I'd recently had a couple of very traumatic surgical experiences, and early in our marriage I would climb the walls with anxiety when her venting hit home to stuff I'd gone thru.
Like most professions, everything seems to be non-stop chaos. I guess that's why they call it "work".
My wife is an RN (BSN at University of Texas) and worked in several hospitals, a nursing home, hospice, etc., When she worked in hospitals she would often come home sounding off about a physician ordering this test or that test (or even surgery) for geriatric patients - even some in their 80s. One situation I remember was a Doc that ordered a colonoscopy for a "little old man in his 80s". She was incensed the Doc put this guy through the hassle of the prep for zero benefit aside from the Doc's wallet.
And on the flip side, she's seen many a family member that won't let go of a patient in palliative care - the family wants anything and everything done to prolong life when there's no clear benefit for the patient.
2014-15: PSA's 9, 12, 20, 25, Neg DRE's, false neg TRUS biopsy
6/16: MRI Fusion biopsy, Right Base, 2x40% + 2x100% G8(4+4)
8/16: DaVinci RP, PNI, 3 foci EPE, 11 LN-, 53g 25% involved, BL SVI, T3b n0m0
1/17: started 18 months Lupron ADT, PSA's ~.03
5/17: AMS800 AUS implanted, revised 6/17
8/17-10/17: RapidArc IMRT 39 tx (70 Gy)
1/18, 4/18: PSA's 0.00, Dx Radiation Colitis...Now what!