• Dagmar Gröber-Grätz, Dirk Mosshammer, Regine Bölter, Dominik Ose, Stefanie Joos, and Iris Natanzon.
• Institut für Allgemeinmedizin, Universität Ulm, Ulm. dagmar.groeber-graetz@uni-ulm.de
• Z Evid Fortbild Qual Gesundhwes. 2011 Jan 1; 105 (6): 446-51.

BackgroundGood cooperation between physicians is an essential requirement for quality health care. General practitioners (GPs) have a key role in coordinating the various levels of care and physician contacts. Within the scope of the "InteraKtion" study of the Competence Centre of General Practice Baden-Wuerttemberg GPs were interviewed about their experiences and opinions regarding their cooperation with specialists. The aim of this study was to identify criteria and barriers of the referral process.Methods22 semi-structured interviews were conducted among GPs in Heidelberg, Tuebingen and Ulm. Data analysis was carried out using ATLAS.ti according to the qualitative content analysis by P. Mayring.ResultsFrom the GPs' point of view, the criteria for referral to specialists include: specialists' medical skills, good doctor-patient relationship and patient satisfaction. In addition, the willingness to arrange short-term appointments in urgent cases, timely diagnosis and adequate communication were mentioned. The following barriers were pointed out: long appointment wait times and the specialists' increased provision of Individual Healthcare Services.ConclusionThese results indicate that GPs have clear criteria for referral to specialists. These findings should find their way into future quantitative studies to explore the weighting of the criteria and barriers discussed here. Joint training activities or quality circles could improve the personal contact between GPs and specialists working in the same region.Copyright © 2011. Published by Elsevier GmbH.

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