Table 1.

Generalists’ Reasons for Referral

Reasons for Referral	%*	Mean ± SD†
Medical reasons
To get advice about therapy	63	2.6 ± 1.5
To obtain assistance with making adiagnosis	58	2.8 ± 1.6
To confirm a diagnosis	46	3.1 ± 1.4
To perform a diagnostic procedure	40	3.1 ± 1.5
To learn more about treatment options	39	3.3 ± 1.5
To perform a therapeutic procedure	38	3.2 ± 1.5
For assistance in ruling out or rulingin a potentially dangerous condition	34	3.6 ± 1.5
To confirm their current managementplan	32	3.5 ± 1.4
Because the patient’s condition was toocomplicated for a generalist to handle	19	3.8 ± 1.2
To have the specialist take overpatient’s care	16	4.1 ± 1.2
To obtain assistance in understandinga lab or radiographic abnormality	7	4.4 ± 0.9
Non-medical reasons
To meet the community standard of care	34	3.3 ± 1.4
To accede to the patient’s request forreferral	33	3.4 ± 1.6
To learn how to deal with similar casesin the future	32	3.6 ± 1.5
To obtain assistance with patienteducation	23	4.0 ± 1.3
To reassure the patient or the patient’sfamily that a serious disease is notpresent	22	3.9 ± 1.4
To motivate the patient to adhere tomedical advice	17	4.2 ± 1.2
To enhance the patient’s trust in theirmedical judgment	10	4.1 ± 1.1
Because they had insufficient time toevaluate the patient thoroughly	8	4.4 ± 1.0
To benefit medical trainees working withthe specialist	8	4.2 ± 1.1
To reduce the risk of medical liability	7	4.3 ± 0.9

^*Percentage of referrals in which generalists, using a 5-point Likert scale, strongly or somewhat agreed that the listed nonmedical reason influenced their decision to refer.

^†Mean ± SD of Likert scale scores, where 1 = strongly agree, 2 = somewhat agree, 3 = uncertain, 4 = somewhat disagree, and 5 = strongly disagree (n = 212 Generalist Postreferral Questionnaires).