The increase was particularly large for cardiac, gastrointestinal, orthopedic, dermatologic, and ear/nose/throat symptoms.

Despite increased attention to the cost and quality of healthcare delivery, little is known about physician-to-physician referrals. Two major national databases were used to assess referrals in about 850,000 ambulatory care visits, with a focus on referrals from primary care physicians from 1999 to 2009.


The rate of visits resulting in a referral to another physician nearly doubled, from 4.8% to 9.3%, during the decade. Referrals from primary care physicians varied with the nature of the problem. Referral rates rose significantly for the following symptoms: cardiac (8.5% to 14.9%), dermatologic (10.1% to 15.4%), ear/nose/throat (4.5% to 8.5%), gastrointestinal (12.3% to 17.7%), and orthopedic (12.4% to 16.5%). Referral rates for other categories of symptoms, such as gynecologic, pulmonary, or urologic, did not change.


Citation(s):

Barnett ML et al. Trends in physician referrals in the United States, 1999-2009. Arch Intern Med 2012 Jan 23; 172:163.