ArticleJournal of general internal medicine1999
Reasons for outpatient referrals from generalists to specialists.
Article in Journal of general internal medicine, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
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The trial behind it
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Who cites it
34 citing papers in PubMed.
- A randomised controlled trial of joint consultations with general practitioners and cardiologists in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2003Trial
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- Optimizing low-density lipoprotein cholesterol (LDL-C) management - a US physician survey of barriers and burdens.American journal of preventive cardiology · 2026Article
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- Development of the electronic consultation long-term care utilization and savings estimator tool to model the potential impact of electronic consultation for residents living in long-term care.Journal of telemedicine and telecare · 2024Article
- Transforming healthcare delivery: a descriptive study of a novel provider-to-provider virtual care platform.Frontiers in public health · 2023Article
- The Changing Face of Head and Neck Cancer; How the Head and Neck One-Stop Clinic Has Evolved Since Conception.Journal of maxillofacial and oral surgery · 2022Article
- Factors used by general practitioners for referring patients with chronic musculoskeletal pain: a qualitative study.BMC primary care · 2022Article
- Disease burden and treatment sequence of polymyositis and dermatomyositis patients in Japan: a real-world evidence study.Clinical rheumatology · 2022Observational
- Today's referral is tomorrow's repeat patient: referrals to and between medical outpatient clinics in a hospital.BMC health services research · 2022Article
- Patient-Identified Problems and Influences Associated With Diagnostic Delay of Acromegaly: A Nationwide Cross-Sectional Study.Frontiers in endocrinology · 2021Article
- Article
- Consultation Intervention Rates for the Otolaryngology Service: A Large Metropolitan Hospital Experience.Spartan medical research journal · 2020Article
- General practitioners referring patients to specialists in tertiary healthcare: a qualitative study.BMC family practice · 2019Article
- Psychiatric Consultation at Your Fingertips: Descriptive Analysis of Electronic Consultation From Primary Care to Psychiatry.Journal of medical Internet research · 2017Article
- Design and Implementation of a Physician Coaching Pilot to Promote Value-Based Referrals to Specialty Care.The Permanente journal · 2017Article
- Pediatrician preferences, local resources, and economic factors influence referral to a subspecialty access clinic.Primary health care research & development · 2016Article
- Typologies in GPs' referral practice.BMC family practice · 2016Observational
- Understanding Patients' Preferences for Referrals to Specialists for an Asymptomatic Condition.Medical decision making : an international journal of the Society for Medical Decision Making · 2015Article
- Examining the variation in GPs' referral practice: a cross-sectional study of GPs' reasons for referral.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the relative importance of medical and nonmedical factors influencing generalists' decisions to refer, and of the factors that might avert unnecessary referrals.
designProspective survey of all referrals from generalists to subspecialists over a 5-month period.
settingUniversity hospital outpatient clinics.
participantsFifty-seven staff physicians in general internal medicine, family medicine, dermatology, orthopedics, gastroenterology, and rheumatology. MEASUREMENTS AND MAIN
resultsFor each referral, the generalist rated a number of medical and nonmedical reasons for referral, as well as factors that may have helped avert the referral; the specialist seeing the patient then rated the appropriateness, timeliness, and complexity of the referral. Both physicians rated the potential avoidability of the referral by telephone consultation. Generalists were influenced by a combination of both medical and nonmedical reasons for 76% of the referrals, by only medical reasons in 20%, and by only nonmedical reasons in 3%. In 33% of all referrals, generalists felt that training in simple procedures or communication with a generalist or specialist colleague would have allowed them to avoid referral. Specialists felt that the vast majority of referrals were timely (as opposed to premature or delayed) and of average complexity. Although specialists rated most referrals as appropriate, 30% were rated as possibly appropriate or inappropriate. Generalists and specialists failed to agree on the avoidability of 34% of referrals.
conclusionsGeneralists made most referrals for a combination of medical and nonmedical reasons, and many referrals were considered avoidable. Increasing procedural training for generalists and enhancing informal channels of communication between generalists and subspecialists might result in more appropriate referrals at lower cost.
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