Evaluation of patient referrals to family physicians in Georgia

Background
Adequate utilization of primary care directly reflects the health status of the population. In Georgia (Republic), many patients seek care without a referral by a primary-care provider, and as a result, patient referral rates to family physicians are low. A tendency of patient self-referral behavior may reduce the effectiveness of the healthcare system.

Objectives
The purpose of the research is to study the problem of the low rate of patient referrals to family physicians in Georgia

Material and methods
Within the quantitative survey, 20 family physicians and 300 patients were interviewed through a semi-structured questionnaire in different regions of Georgia.

Results
Patient referral rates to family physicians are low. 15% (n = 3) of family physicians recognize that patients often address them only for a referral to specialists. Only 5% (n = 3) of family physicians provide preventive consultations on occasion and 50% (n = 10) – in the case of need only. 70% (n = 14) of family physicians think that their remuneration is not adequate for their work and that they work more than they are paid. 35% (n = 105) of respondents in the case of a health problem address both a family physician and a specialist- -physician. 42% (n = 126) of patients visit a family physician once a year or do not visit at all, and 47% (n = 141) of patients believe that the family physician institute needs some changes.

Conclusions
The result suggests that the low rate of patient referrals to family physicians is due to distrust towards family physicians, which is related to a lack of qualification of physicians and low public awareness of the competence of the family physicians. Due to inadequate reimbursement, family physicians do not have enough motivation to provide adequate service, and the lack of continuous professional education negatively affects their professional development. It is recommended to raise public awareness about primary care, to introduce effective methods for payment of family physicians and to increase the role and affordability of continuous professional education.