Abstract
The referral of patients to hospital specialists by general practitioners is a social process involving a series of interactions within and between the primary and secondary sectors of health care. Whilst a range of factors influencing referral decisions have been identified in previous studies, the main focus of this paper is the role of social relationships. Data from thirty interviews with general practitioners is used to show that relationships between doctors (partners and consultants) have a bearing on whether and/or when a patient is referred and to whom. We argued that the major significance of relationships for decision-making is that they are sources of information and thus influence the interpretation of clinical and non-clinical symptoms. We suggest that the concept of social network can usefully describe the informal organisation of relationships between clinicians.
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