Table 2 Factors influencing the quality of a referral for consultation
From: Reasonable requests: echocardiography referral forms as a measure of coherent clinical communication
Diagnostic accuracy | Internal consistency | Appropriateness |
|---|---|---|
Ability to elicit clinical features (clinical competence) | Ability to link findings to pathophysiology | Linkage of clinical differential to potential diagnostic gain |
Technical difficulty in examination of specific patients | Tolerance of non-coherent findings | Integrity (versus inflating information to make referral appear justified.) |
Ownership – personal examination rather than copying from a colleague’s notes | Time constraints and care in generating diagnosis [12] | Impact of clinical team on personal clinical certainty (e.g., a request from a senior to complete a referral form) |