Dataset Information

General practitioners referring patients to specialists in tertiary healthcare: a qualitative study.

ABSTRACT:

Background

There 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.

Methods

Two 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.

Results

Participating 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.

Conclusions

General 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.

SUBMITTER: Tzartzas K

PROVIDER: S-EPMC6885318 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Publications

General practitioners referring patients to specialists in tertiary healthcare: a qualitative study.

Tzartzas Konstantinos K Oberhauser Pierre-Nicolas PN Marion-Veyron Régis R Bourquin Céline C Senn Nicolas N Stiefel Friedrich F

BMC family practice 20191201 1

<h4>Background</h4>There 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.<h4>Methods</h4>Two focus groups were conducted among general practition ...[more]

PMID: 31787078

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Dataset Information

General practitioners referring patients to specialists in tertiary healthcare: a qualitative study.

Background

Methods

Results

Conclusions

Publications

General practitioners referring patients to specialists in tertiary healthcare: a qualitative study.

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