In many situations a physician has a duty to refer a patient to a nonphysician for special care. In some cases, such as patients with psychological problems, there may be physicians who could provide the care, but better or more cost- effective service may be available from a psychologist or professional counselor. Many problems are treated only by nonphysicians. A pediatrician who detects a speech defect in a school-aged child has a duty to see that the child is evaluated and treated by a qualified speech therapist, although the speech therapy itself is beyond the realm of pediatric practice. As with other referrals, a referral to a nonphysician should be discussed with the patient.

A physician has the same duties to ensure quality care for patients with referrals to nonphysicians as when referring to another physician. The attending physician must know that the party accepting the referral is qualified to provide the needed care and willing to accept the care of this patient. The physician does not have an ongoing responsibility to monitor the care provided by the nonphysician but should intervene if there are problems with the care rendered.