ArticleBMC family practice2019
General practitioners referring patients to specialists in tertiary healthcare: a qualitative study.
Article in BMC family practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Systematic review of direct access physiotherapy for musculoskeletal conditions in primary care: consequences for general practitioner workload, resource use, and organisation of care.BMC primary care · 2026Pooled it
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled it
- Diagnostic Reasoning in General Internal Medicine Consultations: A Text Mining Analysis of Consultation Requests.Journal of general and family medicine · 2026Article
- Considerations in referring older patients to hospital in acute situations: a qualitative study based on the experiences of healthcare providers.BMC primary care · 2026Article
- Managing the silent burden: a grounded theory study on urinary incontinence in older women.BMC geriatrics · 2026Article
- Managing patients with mental health conditions in family medicine: a qualitative study exploring the experiences of general practitioners' experiences in Switzerland.Family practice · 2026Article
- Hospital triage of general practice referrals: exploring the role of triage in rejected referrals.BMC health services research · 2026Article
- Management of depression in primary care in Catalonia: a mixed-method study.BMC psychiatry · 2026Observational
- Application of the Theory-Clinical-Community Three-Stage Training Model in General Practitioner Cultivation: A Retrospective Cross-Sectional Survey of an in-Service Continuing Professional Development Program.Advances in medical education and practice · 2026Article
- Article
- Collaboration between general practitioners and psychiatrists via digital platforms in the Netherlands: advantages and specific limiting factors.BMC primary care · 2025Article
- Exploring the Implementation of Multiple Telementoring ECHO Programs From an Institutional and Organizational Perspective: Qualitative Study.JMIR medical education · 2025Article
- Quantifying unmet secondary healthcare need in New Zealand: a multi-year population study using administrative data.BMJ open · 2025Article
- Evaluating referrals between rural district hospitals and a regional hospital in South Africa.African journal of primary health care & family medicine · 2025Article
- Assessing the role of medical entomology in general medicine education in Iran: expert perspectives and curriculum implications.BMC medical education · 2025Article
- General practitioners' experiences with chronic abdominal symptoms and a faecal calprotectin guided referral strategy in children: A Dutch qualitative study.The European journal of general practice · 2024Article
- Does contracting family doctor promote primary healthcare utilization among older adults? - evidence from a difference-in-differences analysis.BMC geriatrics · 2024Article
- Article
- The Role of Homogeneous Waiting Group Criteria in Patient Referrals: Views of General Practitioners and Specialists in South Tyrol, Italy.Healthcare (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a large and unexplained variation in referral rates to specialists by general practitioners, which calls for investigations regarding general practitioners' perceptions and expectations during the referral process. Our objective was to describe the decision-making process underlying referral of patients to specialists by general practitioners working in a university outpatient primary care center.
methodsTwo focus groups were conducted among general practitioners (10 residents and 8 chief residents) working in the Center for Primary Care and Public Health (Unisanté) of the University of Lausanne, in Switzerland. Focus group data were analyzed with thematic content analysis. A feedback group of general practitioners validated the results.
resultsParticipating general practitioners distinguished two kinds of situations regarding referral: a) "clear-cut situations", in which the decision to refer or not seems obvious and b) "complex cases", in which they hesitate to refer or not. Regarding the "complex cases", they reported various types of concerns: a) about the treatment, b) about the patient and the doctor-patient relationship and c) about themselves. General practitioners evoked numerous reasons for referring, including non-medical factors such as influencing patients' emotions, earning specialists' esteem or sharing responsibility. They also explained that they seek validation by colleagues and postpone referral so as to relieve some of the decision-related distress.
conclusionsGeneral practitioners' referral of patients to specialists cannot be explained in biomedical terms only. It seems necessary to take into account the fact that referral is a sensitive topic for general practitioners, involving emotionally charged interactions and relationships with patients, colleagues, specialists and supervisors. The decision to refer or not is influenced by multiple contextual, personal and clinical factors that dynamically interact and shape the decision-making process.
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