[Referral: the meeting point between primary and secondary care]

The growing number of referrals to specialists is a matter of concern to the Government and the 'health insurance collective' (ziekenfonds). In spite of all kinds of measures this increase in referrals continues, also in pediatrics. An effective policy to reverse this trend depends on an understanding of its causes. This paper goes into the mechanisms of supply and demand in health care and the roles of both G.P. and patient in the decision to refer. Parents worry about their children's symptoms. These worries are not always understood by their general practitioner and may lead to referrals in which not medical questions but the worries of the parents take a central place. In treatment at the Out-Patient Clinic consideration should be given not only to the questions, worries and doubts of the G.P., but also to those of the patient and above all the patient's parents.