ANALYZING GENERAL-PRACTITIONERS REFERRAL DECISIONS .2. APPLYING THE ANALYTICAL FRAMEWORK - DO HIGH AND LOW REFERRERS DIFFER IN FACTORS INFLUENCING THEIR REFERRAL DECISIONS

An analytical framework of the referral decision was applied to the qu estion of whether general practitioners (GPs) with relatively high and relatively low referral rates differed in the types of factors that i nfluenced their referral decisions. Interview data from six high refer ring and six low referring GPs were compared at all levels of the fram ework, using both quantitative and qualitative content analysis. High referrers were found to mention significantly more negative factors th an low referrers, i.e. they referred 'in spite of' reasons against ref erral. In particular, they referred patients in spite of having doubts about treatment effectiveness. Low referrers mentioned factors relate d to interpersonal processes significantly more often than high referr ers, for example, GP-patient communication as an influence. Possible i nterpretations of these findings are discussed.