The ongoing struggle to secure patient referrals at each of the program
sites was largely related to referring physicians’ lack of clarity regarding
the program and the process associated with enrolling a patient.
In explaining low referral practices, physicians referenced several perceptions
that inhibited them, including misperceptions about the nature
of service eligibility criteria. Several listed entirely different perceived
criteria for eligibility, indicating an overall lack of clarity about the actual
criteria. Interviews with referring physicians revealed that by far
the most significant barrier to their making referrals to the program was
the perception that referring a patient meant losing control of that patient’s
care and/or being sidelined during decision-making processes.
One high-referring physician asserted that referring doctors were more
likely to be comfortable with referring patients to the program if they
“understand that they will continue to be a part of the patient care team
and have input into patient care.” He suggested that in order to help physicians
feel more at ease with this, the program must engage in ongoing
publicity and do a better job of “selling the teamwork concept” and
“stressing that care is managed as a team.” Clearly communicating the
program requirements, goals, and objectives is critical to assuring the
successful adoption of an innovation.