Primary care practitioners' understanding of physiatric practice: effects on intention to refer.

OBJECTIVES: To learn what family practice and internal medicine physicians understand about the scope of practice of physical medicine and rehabilitation (PM&R) and to study what effect that understanding and various demographic variables have on their intention to refer to physiatrists. DESIGN: Survey-based. SETTING: National survey. PARTICIPANTS: One thousand internal medicine and family practice physicians were contacted, with 460 respondents. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Intention to refer patients to physiatrists using 13 case scenarios (10 appropriate referrals, 4 inappropriate referrals) and self-reported number of referrals per year associated with understanding of 7 skills of physiatrists analyzed by multiple logistic regression analyses. RESULTS: Although most respondents were likely to refer to physiatrists, a wide variation existed in the types of patients referred. Physicians with a greater understanding of the scope of physiatric practice were more likely to refer ( P =.003). Female physicians were more likely to refer than male physicians ( P =.003). CONCLUSIONS: There appears to be an association between an understanding of physiatric practice and primary care practitioners' willingness to refer to PM&R. Primary care physicians should be educated about the benefits of referring patients to physiatrists.