General practitioners’ reflections on referring: An asymmetric or non-dialogical process?

OBJECTIVE: Identify and describe general practitioners' (GPs') reflections on and attitudes to the referral process and cooperation with hospital specialists. DESIGN: Qualitative study using semi-structured focus-group interviews with GPs analysed using Giorgi's method as modified by Malterud. SETTING: Interviews conducted over four months from November 2010 to February 2011. SUBJECTS: 17 female and 14 male GPs aged 29 to 61 years from 21 different practices, who had practised for 3-35 years. MAIN OUTCOME MEASURES: Description of GPs' views on the referral process. RESULTS: GPs wished for improved dialogue with the hospital specialists. The referral process was often considered as asymmetric and sometimes humiliating. GPs saw the benefit of using templates in the referral process, but were sceptical concerning the use of mandatory fixed formats. CONCLUSIONS: The referral process is essential for good patient care between general practice and specialist services. GPs consider referring as asymmetric and sometimes humiliating. The dichotomy between the wish for mutual dialogue and the convenience of using templates should be kept in mind when assuring quality of the referral process.