Physician Referrals and Patient Compliance

Continuing a series of articles about key referral sources and how to reach them...

Physician referrals (Continued)

This first referral source may seem a bit obvious - we all know that primary care physicians refer patients to a specialist when necessary. What is less obvious, however, is how physicians select the surgeons and practices to which they refer. Even less obvious is understanding how physicians decide which patients to refer for surgical assessment, and when. And finally, when a patient is referred to a surgeon, does he or she comply? Why or why not?

Today, we'll answer the final question on physician referrals: when a patient is referred to a surgeon, does he or she comply? Why or why not?

Studies have shown that up to 1/2 of patients are non-compliant when it comes to following their doctor's instructions, and visiting a surgeon is really no different than filling that prescription. It's safe to assume that for every 3 patients referred to your clinic, 1 opts out. But why?

We could spend days discussing patients' objections to seeking treatment from a specialist; I won't pretend that this blog post is exhaustive. However, here are a handful of objections that we actually have the power to impact.

1. Lack of knowledge about the condition and available treatment options. To some, the act of visiting a surgical practice is the same as signing him or herself up to undergo massive surgery. He or she may be unaware of less invasive or non-surgical options, and may wait and wait until symptoms are unbearable before seeking treatment.

2. Suspicion regarding PCP's reasons for referral. I'll admit it. This is me. If my physician refers me to a specialist, I don't blindly call up that particular doc and make an appointment. Rather, I'll get online and do some research to find a specialist that seems highly qualified. There was one exception to this rule, however. My son's pediatrician referred us to an asthma/allergy specialist. Our pediatrician explained to me that he preferred this particular specialist because he has a great deal of experience with kids, and is phenomenal at communicating with the referring physician, making it easier for the pediatrician to effectively manage the patient's care. This helped me to understand the referral (and trust that it wasn't just his med school buddy) and we complied.

3. Patient's choice to visit a different surgeon. Similar to #2, this patient is well-informed. He or she may choose to research specialists online, and may opt to visit a different surgeon based on his areas of specialty, website and reputation. We see this commonly with surgeons who perform minimally invasive surgery - in spite of a referral to another surgeon, patients may seek out a surgeon who performs what they perceive as "cutting edge" procedures.

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