A look at the two–way referral system: experience and perception of its handling by medical consultants/specialists among private medical practitioners in Nigeria

Background: A two-way referral system is an organized two-way relationship between a health care provider or physician in a health care facility at one level of the health care system and another health care provider or physician in a health care facility at the same or higher level of the health care system. In a two-way referral system, there ought to be effective communication between physicians at the same or different levels of the health care system. It is obligatory for the referring physician to refer a patient promptly, in a manner that guarantees efficient, cost-effective, optimal and quality care for the patient. It also requires the physician in the receiving hospital/ health care facility to refer the patient back after treatment, to the health care facility or physician that initiated the referral in the first instance, with clear feedback on the observed findings, investigations conducted for the patient and the treatment given to the patient. This aids effective continuity of care and also updates the referring physician's knowledge. Since an effective, efficient and integrated referral system is vital to the performance of Nigeria's healthcare system, the importance of the practice and perception of the two-way referral system by Private Medical Practitioners in Nigeria, particularly as it affects their relationship with Medical Consultants/ Specialists cannot be over-emphasized.