Gatekeeping and referrals to cardiologists: general practitioners' views on interactive communications

Area of Science:

• Health Services Research
• General Practice
• Cardiology

Background:

• Iceland discontinued mandatory specialist referrals in 1984.
• A 2006 policy reintroduced referrals for cardiologist appointments to facilitate cost reimbursement.
• This shift prompted an investigation into general practitioners' (GPs) perspectives on the referral system.

Purpose of the Study:

• To assess general practitioners' attitudes towards the mandatory specialist referral system.
• To explore the professional gains derived from interactive communication between GPs and specialists.
• To evaluate the impact of the reintroduced referral system on information flow and patient benefit.

Main Methods:

• A cross-sectional questionnaire survey was administered to all practicing GPs in Iceland (n=201).
• The survey collected data on referral processes, reasons for referrals, response letter frequency, and GP attitudes.
• Comparisons were made between rural and urban GP responses.

Main Results:

• A 63% response rate was achieved (126 GPs).
• 98% of GPs found specialist report letters helpful; 64% believed the new referral system improved patient care information.
• Significant differences in referral process aspects were observed between rural and urban GPs.

Conclusions:

• The specialist referral system enhances information exchange and communication between general practitioners and specialists, ultimately benefiting patients.
• Geographical location of healthcare facilities plays a role in the perceived value and effectiveness of specialist referrals.