Self-reported referral patterns in practices of Family/General Practitioners, Internists, and Obstetricians/Bynecologists

Sobal, Jeffery; Muncie, Herbert L.; Valente, Carmine M.; Levine, David M.; DeForge, Bruce R.

doi:10.1007/bf01324242

Cited by 9 publications

(4 citation statements)

References 25 publications

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“…As part of a study of health promotion beliefs and practices of physicians (Sobal et al ,1987(Sobal et al , 1988Valente et al 1985Valente et al , 1986), we mailed a questionnaire to a sample of adult-primary-care physicians in Maryland. The introduction to the questionnaire indicated that it was sponsored by the state medical society.…”

Section: Methodsmentioning

confidence: 99%

Physician Responses to Multiple Questionnaire Mailings

et al. 1990

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Homogeneous groups surveyed about issues of concern to them may require few follow-ups because respondents provide role-specific answers representative of others in that role. The authors analyzed three questionnaire mailings to 1,535 physicians that produced 977 responses (604 first, 252 second, and 85 third mailing). The only demographic or substantive variable significantly different between mailings was medical specialty. This supports the hypothesis that surveys of homogeneous groups, such as physicians in one specialty, may require fewer follow-up efforts. However, using few follow-ups must be done cautiously to avoid nonresponse bias and insure sufficient sample size.The role of physician involves membership in a relatively homogej neous professional group. Physicians are both self-selected and screened by admissions committees, and also subjected to a long and standardized process of socialization into the physician role. As important decision makers in the health care system, physicians are frequently surveyed AUTHORS' NOTE: The authors thank Susan Malamet for assistance tn selecting the sample.

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Section: Methodsmentioning

confidence: 99%

Physician Responses to Multiple Questionnaire Mailings

et al. 1990

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“…The format of the guidelines included information on assessment and treatment before referral, not just indications to refer. Because physician inexperience may result in increased referrals, 16 referral guidelines that include information regarding assessment and treatment before referral may affect rates of referrals. Such a combined referral and educational tool may have affected the treatment by the PCP, which might have subsequently changed referral decision making.…”

Section: Discussionmentioning

confidence: 99%

“…Many reasons have been identified that can influence the referral process. Physicians in metropolitan areas or those with ready access to medical resources and tertiary care centers tend to refer more frequently 15 , 16 . Increased rates of referrals have also been identified in young physicians or in those who spend less time in patient care, 16 although in some cases greater familiarity with the field of specialty may result in more frequent referrals 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Physicians in metropolitan areas or those with ready access to medical resources and tertiary care centers tend to refer more frequently 15 , 16 . Increased rates of referrals have also been identified in young physicians or in those who spend less time in patient care, 16 although in some cases greater familiarity with the field of specialty may result in more frequent referrals 17 . Referrals for eye care services are most common for acute, symptomatic disorders rather than for known or chronic ocular conditions 18 .…”

Section: Discussionmentioning

confidence: 99%

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Management guidelines for improvement of otolaryngology referrals from primary care physicians

Benninger

King

Nichols

1995

Otolaryngol.--head neck surg.

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OBJECTIVE AND DESIGN: A prospective evaluation of the effectiveness of otolaryngology evaluation, treatment, and referral guidelines developed collaboratively by otolaryngologists and primary care physicians on referrals and access to otolaryngology. Comparisons of appropriate to unnecessary referrals, the percentage of patients referred with disorders addressed to those without disorders addressed in the guidelines, access to otolaryngology, and questionnaire evaluations of primary care physician and patient satisfaction were measured before and after guideline implementation. RESULTS: A significant decrease in appropriate to unnecessary referrals was seen, from 55% before to 12% after guidelines. The percentage of patients seen within 1 month of scheduling improved from 39% to 59%. Guideline-addressed disorders decreased from 63% to 40%. The need for patients to see another physician for the referred symptom while waiting to see an otolaryngologist decreased from 31 % to 3%. Patient satisfaction with wait times improved. Eighty-six percent of the primary care physicians used the guidelines, and 85% wanted to expand the guidelines to other specialty areas. CONCLUSIONS: Management and referral guidelines are effective in improving patient access and the ratio of appropriate to unnecessary referrals. Such guidelines are well accepted and used by primary care practitioners in this setting.

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The Case for Case-Mix Adjustment in Practice Profiling

Salem‐Schatz¹

1994

JAMA

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Failure to adjust for case mix in physician practice profiles may lead to overestimates of variation and misidentification of outliers. To the extent that unadjusted practice profiles are used for decisions about education, sanctions, or employment, physicians may be subject to inequitable decisions and actions. Misinformation about the causes and extent of practice variation may also lead to misdirection of scarce resources for quality improvement efforts.

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Self-reported referral patterns in practices of Family/General Practitioners, Internists, and Obstetricians/Bynecologists

Cited by 9 publications

References 25 publications

Physician Responses to Multiple Questionnaire Mailings

Physician Responses to Multiple Questionnaire Mailings

Management guidelines for improvement of otolaryngology referrals from primary care physicians

The Case for Case-Mix Adjustment in Practice Profiling

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