Typologies in GPs’ referral practice

Abstract

BackgroundGPs’ individual decisions to refer and the various ways of working when they refer are important determinants of secondary care use. The objective of this study was to explore and describe potential characteristics of GPs’ referral practice by investigating their opinions about referring and their self-reported experiences of what they do when they refer.MethodsObservational cross-sectional study using data from 128 Norwegian GPs who filled in a questionnaire with statements on how they regarded the referral process, and who were invited to collect data when they actually referred to hospital during one month. Only elective referrals were recorded. The 57 participants (44,5 %) recorded data from 691 referrals. The variables were included in a principal component analysis. A multiple linear regression analysis was conducted to identify typologies with GP’s age, gender, specialty in family medicine and location as independent variables.ResultsEight principal components describe the different ways GPs think and work when they refer. Two typologies summarize these components: confidence characterizing specialists in family medicine, mainly female, who reported a more patient-centred practice making priority decisions when they refer, who confer easily with hospital consultants and who complete the referrals during the consultation; uncertainty characterizing young, mainly male non-specialists in family medicine, experiencing patients’ pressure to be referred, heavy workload, having reluctance to cooperate with the patient and reporting sparse contact with hospital colleagues.ConclusionsTraining specialists in family medicine in patient-centred method, easy conference with hospital consultant and cooperation with patients while making the referral may foster both self-reflections on own competences and increased levels of confidence.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0495-y) contains supplementary material, which is available to authorized users.

Physical Therapists’ Ability to Distinguish Between Inflammatory and Noninflammatory Arthritis and to Appropriately Refer Patients to a Rheumatologist

“…Furthermore, PTs who work in the public sector, those working in a practice with a physician, as well as those working in urban centers, may have had more contact with rheumatologists and may be more inclined to refer. Although we have no previous data regarding PTs, there is evidence that primary care physicians' referral patterns to specialists are related to case mix, physician sex, experience, specialty, comfort with the diagnosis, degree of physician specialization, type of practice, and location of practice (such as rural or urban setting) (30)(31)(32)(33).…”

Self-reported sick leave following a brief preventive intervention on work-related stress: a randomised controlled trial in primary health care

“…In concordance, collaborations with patients and colleagues are seen as important elements in the referral process. 47 However, according to GPs, other aspects such as reluctance to cooperate with patients and sparse contact with colleagues could affect the referral process 47 and the measures taken. Taken together, factors related to the study setup might have diluted the effect of the intervention, so that no difference in self-reported sick leave days was detected, even for the subsamples highly exposed to stressors.…”

What non-clinical factors influence the general dentist–specialist relationship in Canada?

“…Such relationships are said to improve patient-centered care, the effectiveness of care, as well as the patient experiences and outcomes [ 1 ]. In dentistry, the main interface of the general dentist and specialist is through the referral process [ 2 , 3 ]. During this interaction, both practitioners can exhibit positive or negative attitudes and behaviors toward one another.…”