CSIRO Publishing blank image blank image blank image blank imageBooksblank image blank image blank image blank imageJournalsblank image blank image blank image blank imageAbout Usblank image blank image blank image blank imageShopping Cartblank image blank image blank image You are here: Journals > Australian Journal of Primary Health   
Australian Journal of Primary Health
  The issues influencing community health services and primary health care
blank image Search
blank image blank image
blank image
  Advanced Search

Journal Home
About the Journal
Editorial Board
Online Early
Current Issue
Just Accepted
All Issues
Special Issues
Sample Issue
For Authors
General Information
Instructions to Authors
Submit Article
For Referees
Referee Guidelines
Review Article
Annual Referee Index
For Subscribers
Subscription Prices
Customer Service
Print Publication Dates

blue arrow e-Alerts
blank image
Subscribe to our email Early Alert or RSS feeds for the latest journal papers.

red arrow Connect with CP
blank image
facebook twitter youtube


Article << Previous     |     Next >>   Contents Vol 16(2)

General practitioners’ decision to refer patients to dietitians: insight into the clinical reasoning process

Sylvia E. M. Pomeroy A C, Robyn P. Cant B

A Bayside General Practice Network, Cheltenham, Vic. 3192, Australia.
B School of Nursing and Midwifery, Monash University Gippsland Campus, Vic. 3842, Australia.
C Corresponding author. Email: spomeroy@iprimus.com.au
PDF (176 KB) $25
 Export Citation


The aim of this project was to describe general practitioners’ (GPs’) decision-making process for reducing nutrition risk in cardiac patients through referring a patient to a dietitian. The setting was primary care practices in Victoria. The method we employed was mixed methods research: in Study 1, 30 GPs were interviewed. Recorded interviews were transcribed and narratives analysed thematically. Study 2 involved a survey of statewide random sample of GPs. Frequencies and analyses of variance were used to explore the impact of demographic variables on decisions to refer. We found that the referral decision involved four elements: (i) synthesising management information; (ii) forecasting outcomes; (iii) planning management; and (iv) actioning referrals. GPs applied cognitive and collaborative strategies to develop a treatment plan. In Study 2, doctors (248 GPs, 30%) concurred with identified barriers/enabling factors for patients’ referral. There was no association between GPs’ sex, age or hours worked per week and referral factors. We conclude that a GP’s judgment to offer a dietetic referral to an adult patient is a four element reasoning process. Attention to how these elements interact may assist clinical decision making. Apart from the sole use of prescribed medications/surgical procedures for cardiac care, patients offered a dietetic referral were those who were considered able to commit to dietary change and who were willing to attend a dietetic consultation. Improvements in provision of patients’ nutrition intervention information to GPs are needed. Further investigation is justified to determine how to resolve this practice gap.

Keywords: nutrition.

Subscriber Login

Legal & Privacy | Contact Us | Help


© CSIRO 1996-2014