Summary
Let a GP send a specialist a question with the record, photos and results attached, and get advice back in about a day. Large programmes have avoided about half of planned referrals this way. Offer patients a second opinion on the same footing, with the specialist reading the whole record before writing.
Many referrals only needed one answer. In Ontario, 60,474 e-consults received a median specialist reply in one day, and a referral the GP had planned was avoided 51% of the time.1
For a private clinic, the same model keeps the patient with their GP, gets the specialist's view in days, and gives specialists paid work they can do between sessions.
See it in your clinicSee a GP's question reach a dermatologist with the photos attached, and the answer come back the next day.
Request a demo| Programme | Median reply | Referrals avoided |
|---|---|---|
| Ontario, all specialties, 60,474 e-consults | 1 day | 51% |
| Rheumatology | 1.9 days | 38% |
| ENT | Not reported here | 33% |
Most referrals ask one question
A GP who refers a pigmented lesion usually wants to know whether to watch it or remove it. Answered by a referral, that question costs the patient weeks and a new appointment. Answered by a specialist reading the photos, it takes a day.
The evidence is consistent across specialties. Rheumatology e-consults avoided 38% of referrals with a median reply of 1.9 days,2 and ENT e-consults avoided about a third.3
Ask with the record attached
The question should travel with everything the specialist needs, the history, the medicines, the photos and the results, so the specialist never has to write back to ask.
The specialist replies with advice, a plan, or a request to see the patient. The GP stays responsible for the patient and the specialist for the advice, the split the GMC expects when doctors share care. Referrals that still need a visit are covered in referral intake and triage.
Pay specialists for answers
E-consult programmes work when specialists are paid for the answer. The fee should be shown before the specialist accepts and paid through the clinic, the same model that runs doctor on demand.
In the US, interprofessional consultation codes can apply where a clinic bills insurance, and the specialist needs a licence in the patient's state.
Second opinions on the whole record
Patients facing a big decision, surgery or a long treatment, often want a second opinion. The second doctor usually starts with a letter and little else.
A second opinion on the full record, the scans, letters, notes and results, is a better service and an easier one to deliver. The specialist opinions feature is being built with design partner clinics.
Tell us which specialties your GPs refer to most and we will show you the questions that could have been e-consults.
Request a demoFrequently asked questions
What is a specialist e-consult?
A written question from one clinician to a specialist, with the record attached, answered asynchronously with advice, a plan or a request to see the patient.
Do e-consults reduce referrals?
Yes. In Ontario, 51% of e-consults avoided a referral the GP had planned.1
Who is responsible for the patient after an e-consult?
The clinician who asked stays responsible for the patient. The specialist is responsible for the advice.
How fast do specialists reply?
Large programmes report a median of about one day.1
Can patients request a second opinion themselves?
In many clinics they can. It works best when the specialist reads the full record before writing the opinion.
Sources
- Ontario eConsult, a decade of service, read 18 October 2026
- Rheumatology eConsults, read 18 October 2026
- Otolaryngology eConsults and avoided referrals, read 18 October 2026
Give your GPs a specialist's answer tomorrow.
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Read how specialist opinions works in a clinic