1. Factors influencing General Practitioner referral patterns to Orthopaedic Surgeons in the Australian Health Care setting: an on-line survey AOA New South Wales Branch Meeting 19 th August 2011 David Loxton MBBS FRACGP FACRRM

2. Acknowledgements Fellow Authors: Stephen Barnett. Senior lecturer in general Practice. Graduate School of Medicine. University of Wollongong Patricia Knight. Research Fellow. Community based health education. Graduate School of Medicine. University of Wollongong. Statistician: Andrew Bonney. Senior lecturer in General Practice. Graduate School of Medicine. Scientific Director Primary Care and Rural Health. Illawarra Health and Medical Research Institute. University of Wollongong

3. Ethics and Financial Interest statement Application approved 30 June 2011. Ethics number HE11/271 University of Wollongong Health and Medical Human Research Ethics Committee. None of the authors have received any payment or consideration from any source for the conduct of this study.

4. Aim To use the member database of e- healthspace.com.au to identify and quantify the factors that influence General Practitioners when referring patients to a particular Orthopaedic Surgeon

5. Method On line Survey of 9495 General practitioners who are registered on www.ehealthspace.com.au www.ehealthspace.com.au Seven point Likert scale used to rank responses from extremely positive to extremely negative to various factors that influence decisions to refer patients to an Orthopaedic Surgeon

6. Questions 5 broad categories Professional and personal reputation Communication Style of practice Promotional activities Access and cost

7. Instructions: For each of the questions below, please indicate your responses by placing a cross in the appropriate box. When you are deciding to which Orthopaedic Surgeon you will refer a patient, for semi urgent or an elective orthopaedic surgical opinion or treatment, please indicate the following:

8. Results 476 respondents. 407 proceeded beyond the demographic questions. Demographic Questions: Practice location Length of time in practice.

9. General Practitioners- Location of Practice

10. General Practitioners – Years in Practice

16. Most positive factors Technical expertise 98% positive Prompt reporting of opinion and management plan 97% positive Ability to speak personally 95% positive Prompt provision of discharge summary 94% positive Good Rapport with patients 93% positive

17. Least positive factors Direct advertising to patients 4% positive Advertising in the media 12% positive Delegation of consultation 14% positive On- referral without discussion 16% positive Advertising of revolutionary surgical techniques 37% positive Education sessions for patients 48% positive

18. Conclusion The preferred referral surgeon for General Practitioners is Affable Able Available Some things have not changed……….