The Two-way Referral System: A Survey of Medical and Dental Consultants in a Tertiary Hospital in Nigeria

Background: Referral has been defined as a set of activities undertaken by a health care provider or facility in response to its inability to provide the necessary intervention to satisfy a patient’s need. In a referral process, both Medical and Dental Consultants (Specialists) and Primary care physicians have essential roles to play. This study assessed the knowledge and practice of the two-way referral system by Medical and Dental Consultants in a tertiary hospital and their attitude towards it.

Methodology: This was a descriptive cross-sectional questionnaire-based study of Medical and Dental Consultants in a tertiary hospital. Data analysis was done using IBM SPSS Statistics version 21.0 (Chicago, IL, USA) statistical software, with Pearson's chi-square used to determine associations between variables. Statistical significance was set at a P-value of < 0.05.

Results: There were 118 respondents with 84 males and 34 females (M: F = 1:0.4). Though most of them had good knowledge of the two-way referral system, only 13.6% always referred the patient back to the primary care physician after specialist treatment. Of the respondents who never referred the patient back to the primary care physician, 44.4% stated there was no need for feedback to the primary care physician because they felt the patient became theirs after the initiation of a referral to them (specialist).

Conclusion: Though most of the Medical and Dental Consultants were aware of the two-way referral system and had good knowledge of it, their practice of the two-way referral system was poor.