Rheumatic disease, the family physician, and the consultants: when to hold them and when to fold them.

The principles of when to refer in rheumatologic disorders vary little from the general pattern, but some disease-specific advice is helpful. Follow the age-old tenets of referring if diagnosis is uncertain, if treatment advice is needed, or if you are unable to meet the many needs of patients with chronic illnesses. It is often valuable to ask why the patient wants a referral. Education, referral to allied health professionals, and assessing how well you are supporting the patient are all important. It is also essential to maintain contact with both patient and consultant if referral is necessary.