Refusing Inappropriate Referral Requests

Understanding Inappropriate Referrals

• Inappropriate referrals can be defined as requests for specialist care that cannot accomplish the intended clinical goal, according to the American Thoracic Society 1, 3
• Inappropriate referrals can also be defined as requests that fall outside the bounds of accepted medical practice, as stated by the American College of Physicians 4

Ethical and Clinical Framework for Refusing Inappropriate Referrals

• When refusing a referral, physicians should clearly explain why the requested referral is not medically indicated, as recommended by the American Academy of Family Physicians 1, 2
• Physicians should document the clinical reasoning behind considering the referral inappropriate, as suggested by the American Medical Association 4
• In time-pressured situations, physicians should still ensure their decisions are based on clear facts and verified assumptions, according to the American College of Physicians 4