Referral conversations vs direct messages, and what belongs in each

Both kinds of conversation live under Messages in the sidebar, and the unread count there covers both. The filters above the list separate them: All shows everything, Unread shows what you have not read, Referrals shows conversations attached to a referral, and Direct shows direct messages between two people.

A referral conversation inherits the referral's access rules and its consent gate. A direct message has no referral behind it, so it has no patient context and no consent record to sit behind. Which one you are in decides what is appropriate to write.

You can tell them apart from inside the conversation. A referral conversation names the patient at the top, shows the referral's status, and offers Open Referral. A direct message names the other provider, marked Direct message, offers View Profile instead of a link to any referral, and reads No patient details above the message box.

Open a referral you sent and its Messages card lists a conversation for each practice that has the referral. On one you received, it holds one conversation, with the practice that sent it; a referral from outside Syncroly has none. Select a practice to open its conversation, where you can write, attach files, and read the history. To write to another practice, close it and select that one. The same threads appear under the Referrals filter in Messages, so you can work from either place.

A thread is scoped to one referral and one recipient practice. If you sent a referral to three practices, you have three separate conversations, and no recipient practice can see the messages you exchanged with another.

A dot before a practice's name marks a message you have not read, and a conversation nobody has written in yet reads No messages yet. Until a practice can see the referral, the card says Messages open once a practice has the referral., or Messages open when a practice joins. for a practice not on Syncroly yet.

A direct message is a conversation between you and one other provider, with no referral behind it.

Because there is no referral, there is no patient, no consent record, no referral status, and no Open Referral link. That is what makes it the right place for the questions that are not about a specific case, and the wrong place for the ones that are.

Every direct message reads No patient details above the message box, and the notice cannot be dismissed.

There are three ways in:

• In Messages, select New Direct Message and search for the provider by name. The search finds providers in your category, including those at other practices.
• Type their name in Search patients, practices, providers... at the top of Messages and pick them under Providers.
• On their profile, select Message.

Only the two of you can read a direct message, not your team or theirs. The New Direct Message dialog says so, and so does the conversation until someone writes in it. About a patient? Search the patient's name instead and write in that referral's conversation.

Front desk can't use direct messages, and a read-only role can't start one.

Anything about a specific patient belongs in that patient's referral conversation. Names, contact details, dates of birth, clinical findings, scans, and records all have a referral to sit behind, and that referral is where the consent, the access rules, and the audit trail already are.

A direct message is for everything that is not about an identified patient: introducing yourself to a practice, asking what a colleague treats, checking whether they are taking new cases. Keep patient identifiers out of it.

If the practice you want to write to has not been sent a referral yet, that is the signal to send one rather than to describe the patient in a direct message. Sending the referral creates the conversation you need, with the consent gate and the access rules already applied.

A referral conversation is a practice-to-practice channel, not a private line between two people. On the sending side, colleagues at your practice can read it. On the receiving side, colleagues at the recipient practice can read it once that practice has been notified and the referral's consent is recorded. Your practice's visibility setting narrows this the same way it narrows the inbox: a provider limited to their own referrals sees only the conversations on those referrals. See Inbox visibility: who on your team sees what.

A direct message is narrower. Only the two providers in the thread can open it, and a colleague at either practice cannot read it. Deactivating a member ends their access to both kinds of conversation.

Message bodies are encrypted at rest in both channels, and message and file activity is written to the audit log in both. The difference between them is scope and consent, not encryption.

By Practice groups conversations under each practice, so a practice you both refer to and message directly appears once with its conversations underneath. By Date lists every conversation newest first.

To find one, use Search patients, practices, providers... at the top of Messages. Pick a patient to open that referral's conversation, a practice to see its conversations or start one, or a provider to open your direct message with them. Search does not look inside messages.

When a message arrives and you have not read it, Syncroly emails you a link that opens the thread. Messages have a 2,000 character limit, and the counter appears as you approach it.