SynthesisJournal of general internal medicine2022
How Referring Providers Choose Specialists for Their Patients: a Systematic Review.
Synthesis in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed.
- CMC-ID: identifying children and youth with medical complexity using an electronic health record.BMJ health & care informatics · 2026Article
- Are the Best Worth the Wait? Physician Quality Scores and Access Delays.Health services research · 2026Article
- Trends Over 10 Years in Surgeons Performing Mandibular Distraction Osteogenesis in Infants: A National Cohort Study.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2026Article
- Adequacy of electronic and in-person referrals to endocrinology: a prospective study of primary care and hospital consultations.Frontiers in endocrinology · 2026Article
- Public preferences for preventative dental care: a discrete choice experiment in China.Frontiers in public health · 2026Article
- Referrals and Black-White Coronary Heart Disease Treatment Disparities: A Qualitative Study of Primary Care Physician Perspectives.Journal of general internal medicine · 2025Article
- Factors affecting general practitioners' referrals of patients to hip and knee arthroplasty: a focus group study from Northern Norway.BMC health services research · 2025Article
- Urban Indian healthcare referral system: A qualitative exploration from the physicians' perspectives.PloS one · 2025Article
- Comparison of Simulated Outcomes of Colorectal Cancer Surgery at the Highest-Performing vs Chosen Local Hospitals.JAMA network open · 2023Article
- Simulated data-driven hospital selection for surgical treatment of well-differentiated thyroid cancer in older adults.Surgery · 2023Article
- "My Quality of Life is Not There. I'm Dying Here. I Cannot Take This Anymore." Exploring Patient Experiences With Surgical Wait Times in Otolaryngology: A Mixed Methods Study.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-facialeArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundPhysician referrals are a critical step in directing patients to high-quality specialists. Despite efforts to encourage referrals to high-volume hospitals, many patients receive treatment at low-volume centers with worse outcomes. We aimed to determine the most important factors considered by referring providers when selecting specialists for their patients through a systematic review of medical and surgical literature.
methodsPubMed and Embase were searched from January 2000 to July 2021 using terms related to referrals, specialty, surgery, primary care, and decision-making. We included survey and interview studies reporting the factors considered by healthcare providers as they refer patients to specialists in the USA. Studies were screened by two independent reviewers. Quality was assessed using the CASP Checklist. A qualitative thematic analysis was performed to synthesize common decision factors across studies.
resultsWe screened 1,972 abstracts and identified 7 studies for inclusion, reporting on 1,575 providers. Thematic analysis showed that referring providers consider factors related to the specialist's clinical expertise (skill, training, outcomes, and assessments), interactions between the patient and specialist (prior experience, rapport, location, scheduling, preference, and insurance), and interactions between the referring physician and specialist (personal relationships, communication, reputation, reciprocity, and practice or system affiliation). Notably, studies did not describe how providers assess clinical or technical skills.
conclusionsReferring providers rely on subjective factors and assessments to evaluate quality when selecting a specialist. There may be a role for guidelines and objective measures of quality to inform the choice of specialist by referring providers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.