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J R Soc Med. 1991 July; 84(7): 403–404.
PMCID: PMC1293329

Should general practitioners refer more patients to hospital?


Twenty-two patients with skin problems were identified on the basis that their general practitioner was satisfied with their management and had no intention of referring them to hospital. These patients were reviewed by one of two dermatologists who made treatment recommendations in 14 cases, and these suggestions were taken up by 11 patients. Six patients reported definite subjective improvement in their skin condition six weeks later. The general practitioners found the consultation valuable in 17 cases. Although these patients might have improved without the dermatologists' intervention, a group of patients may exist who would benefit from specialist advice, even though that advice has not been sought. Restriction on hospital referrals could therefore be detrimental to patient care. Controlled trials could be conducted to determine the benefit of specialist advice on patients not currently seen in hospital.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Wilkin D, Smith A. Explaining variation in general practitioner referrals to hospital. Fam Pract. 1987 Sep;4(3):160–169. [PubMed]
  • Keefe M, Dick DC. Dermatologists should not be concerned in routine treatment of warts. Br Med J (Clin Res Ed) 1988 Jan 16;296(6616):177–179. [PMC free article] [PubMed]
  • Roland MO, Dixon M. Problems in setting standards for hospital referrals: experience with warts. BMJ. 1989 Sep 9;299(6700):658–659. [PMC free article] [PubMed]
  • Sladden MJ, Graham-Brown RA. How many GP referrals to dermatology outpatients are really necessary? J R Soc Med. 1989 Jun;82(6):347–348. [PMC free article] [PubMed]
  • Roberts MM, Elton RA, Robinson SE, French K. Consultations for breast disease in general practice and hospital referral patterns. Br J Surg. 1987 Nov;74(11):1020–1022. [PubMed]

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