Physician Referral Responsibilities

General physicians are often presented with patients that they do not have the expertise to properly treat. To respond to this problem, doctors refer their patients to outside specialists. However, there are several conflicts of interest, and it is imperative that they refer patients based on sound and honest principles.

Specialization

• The most important responsibility of a physician referral is that the doctor has the correct specialization to handle the patient. If the doctor does not have the capability or correct specialization, the original referring doctor bares some responsibility for the error. For example, a patient with cancer should be referred to an oncologist. If the patient is a child, the physician must be a pediatric oncologist.

Trust

• Physicians have the responsibility to trust that the doctor they are referring is qualified and capable. A doctor who refers a poor specialist can be held to some degree of liability, and therefore must ensure that the physician is excellent. In addition, it helps their own credibility to send a patient to a superior doctor. Trust is an important responsibility for all doctors when making referral decisions.

Fee Splitting

• A doctor has the responsibility to not accept any payment or fee for the referral of a patient to another doctor. Such a fee is considered unethical because it may influence the referral. According to the AMA's Code of Conduct, a referral payment or fee split by a doctor, clinic, hospital or pharmaceutical firm is expressly prohibited.

Tracking Outcomes

• Physicians also have the responsibility to track the outcomes of the patients that they refer. Rather than anecdotal evidence, doctors must track through notation and recording to determine if the doctors they are referring provide positive outcomes. Otherwise, the physician should begin to refer patients to other doctors. This may be a little subjective because some patients may be too sick to reach a positive outcome from any doctor.