General practitioner outpatient referrals: do good doctors refer more patients to hospital?

Objective: To investigate the relation between general practitioners' referral rates to individual specialties and the individual areas of expertise of the referring doctors.

Design: Data collected on referral patterns in one group practice over nine months.

Setting: General practice in suburban Birmingham consisting of five partners and a trainee.

Results: In 395 referrals there were large differences in referral patterns among partners for otorhinolaryngology, ophthalmology, general surgery, and dermatology. The doctors with particular expertise in otorhinolaryngology and ophthalmology had high referral rates to those specialties, and these differences persisted after allowing for case mix.

Conclusion: A high referral rate does not necessarily imply a high level of inappropriate referral.