Referral decisions differ between primary care physicians and specialists
How do physicians decide which colleague to refer their patient to? It differs depending on whether you ask primary care or specialist physicians, according to research from Harvard Medical School, Brigham and Women's Hospital, and Beth Israel Deaconess Medical Center in Boston, USA, led by Michael Barnett. Primary care physicians are more likely to cite reasons relating to patient access or physician-to-physician communication whereas medical or surgical specialists cite reasons related to patient experience with the chosen physician. Barnett and colleagues' work appears online in the Journal of General Internal Medicine.
Barnett and team examined reasons why primary care and specialist physicians choose certain specific colleagues to refer to, and how those reasons differ by speciality. Using a web-based survey, they asked 616 physicians, who treated 46,937 Medicare patients in 2006, about their referral and information-sharing relationships with other physicians of any speciality.
The researchers first identified referral relationships for each physician. They then asked respondents to identify the two most important reasons for choosing a specific physician the last time they referred a patient to him or her. They grouped reasons for referral into three categories: patient experience with physician; patient access; and physician-to-physician communication. Clinical expertise as a criterion was excluded from the list of reasons because in pre-testing, physicians uniformly chose it as the most important criteria for referral and this enabled them to examine how physicians choose among physicians of similar quality.
Primary care physicians initiated two-thirds of their referrals within their professional network, whereas medical and surgical specialists initiated half of their referrals within their networks. Overall, physicians of all specialities most frequently cited "my patients have good experiences with this physician" among the choices given as the most important reason for selecting that physician, besides clinical expertise.
Specialists and primary care physicians, however, also gave different reasons for choosing referral partners. Specialists were more likely to rely on patient experience with physicians whereas primary care physicians relied more on patient access and physician communication.
To date, much of the work looking at the referral process has focused on primary care physicians as the sole source for referrals, consistent with their role as coordinators of care. The substantial proportion of referral relationships cited by specialists, however, shows that specialists also influence the mix of physicians a patient sees.
The authors conclude: "This study is the first to explore differences in the referral decisions between primary care and specialist physicians. Our findings suggest that interventions to influence referral practices will need to be tailored by speciality."
More information: Barnett ML et al (2011). Reasons for choice of referral physician among primary care and specialist physicians. Journal of General Internal Medicine. DOI 10.1007/s11606-011-1861-z
Provided by Springer
- It's complicated: Despite the challenges, collaboration is key in kidney disease care Jan 06, 2011 | not rated yet | 0
- Primary care physicians nationwide face clinical ethical conflicts with religious hospitals Apr 09, 2010 | not rated yet | 0
- How effective are dental referrals by primary care physicians? Jul 04, 2008 | not rated yet | 0
- Minority health-care clinics separate but unequal Feb 09, 2009 | not rated yet | 0
- Characteristics of patient panels appear associated with quality ratings of primary care physicians Sep 07, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
Calorie information in fast food restaurants used by 40 percent of 9-18 year olds when making food choices
A new study published online today (Thursday) in the Journal of Public Health has found that of young people who visited fast food or chain restaurants in the U.S. in 2010, girls and youth who were obese were more likely ...
Health 3 hours ago | not rated yet | 0
(HealthDay)—Implementation of systematic monitoring for medication adherence will allow for identification of barriers to adherence and tailoring of interventions, according to a viewpoint piece published ...
Health 5 hours ago | not rated yet | 0
(AP)—The Obama administration says more doctors and hospitals are embracing technology as adoption of computerized medical records reaches a "tipping point" in America.
Health 6 hours ago | not rated yet | 0
Johns Hopkins researchers report that hospitals may be reaping enormous income for patients whose hospital stays are complicated by preventable bloodstream infections contracted in their intensive care units.
Health 6 hours ago | not rated yet | 0
A University of Illinois researcher says that the cornerstone of our efforts to alleviate food insecurity should be to encourage more people to participate in the Supplemental Nutrition Assistance Program (SNAP) "because ...
Health 7 hours ago | not rated yet | 0
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
9 hours ago | 4.8 / 5 (5) | 0 |
Researchers from Queen Mary, University of London have led the largest sequencing study of human disease to date, investigating the genetic basis of six autoimmune diseases.
9 hours ago | 4 / 5 (1) | 0 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
6 hours ago | 5 / 5 (2) | 2 |
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
6 hours ago | 5 / 5 (1) | 0 |
A new approach for immunizing against influenza elicited a more potent immune response and broader protection than the currently licensed seasonal influenza vaccines when tested in mice and ferrets. The vaccine ...
6 hours ago | not rated yet | 0 |
In a series of lab experiments designed to unravel the workings of a key enzyme widely considered a possible trigger of rheumatoid arthritis, researchers at Johns Hopkins have found that in the most severe ...
8 hours ago | 5 / 5 (1) | 0 |