When we refer somebody, we give them a certain referral form.
This is consistent with findings in previous studies [ 4, 24], which have also found that patients with certain referral conditions (e.g. myocardial infarction) demonstrate much higher (even doubled) adherence rates than other referral conditions (e.g. mental illness).
We usually use more rational arguments related to what is best for the patient, then we argue that the patient will not benefit much from a certain referral and therefore we will not refer.
For example, certain referral questions are addressed more efficiently through consultation or information exchanges between the referring PCP and the specialist, which does not necessarily require a physical encounter between the patient and the specialist [ 9].
This could have been a source of bias, but we could only collect and link the data from consultants, GPs and patients regarding a certain referral process, but not with individual patient data.
As a result, their availability is limited to certain specialist referral centers.
And they can only take a certain amount of referrals a week – so they might be full by Monday afternoon; that's hardly a rapid response.
For instance, requests for certain diagnostic procedures, referrals, or sick leave certificates must sometimes be turned down.
For all patients, a certain proportion of referrals to specialist may be cancelled or result in a no show.
Consultation time is very short, (observed to average around 2 minutes), during which patients demand certain drugs or referrals to hospitals for diagnostics or treatment.
