Before referring a patient to a specialty institution, the physician and the patient should decide to what extent the physician will provide continuing care to that patient. Even physicians who no longer provide care after the referral should follow up to make sure that the referral was received and that the patient is being cared for. If the original physician will continue to provide some care for the patient or take the patient back after the special care, he or she should keep abreast of the patient’s care at the referral center. Too often, the patient is the only source of information the community physician has. Checking with the patient or family during the course of treatment helps maintain a good relationship and may allow the physician to intervene if necessary.

The referring physician should make sure that complete records on the treatment provided at the referral center accompany the returning patient. The referring physician should insist on receiving copies of any operative reports, significant test results, and discharge summaries. If it is difficult to get such information from the referral center, the physician should consider getting a release from the patient and formally requesting a copy of these sections of the record. The medical records administrator of a large hospital is likely to be prompter and more thorough in honoring such requests than a resident who has moved to another service.