Referral patterns of family physicians in an underserved rural area.

This paper examines the rates and patterns of referral of four family physicians in an underserved rural area of Washington State. The majority of referrals made by the family physicians were for management of a particular problem outside the scope of practice of the physician. The referral rates ranged from 1.8 to 3.2 percent of all patient visits and were comparable with those previously reported. A National Health Service Corps physician had the highest rate of referral and a foreign medical graduate had the lowest rate of referral. These results may be explained by practice building incentives as well as the ability to establish ties with the referral network.