Altering physician referral practices is challenging, but not impossible: spine assessment clinic quality improvement study

While challenges remain when attempting to modify the referring behaviours of primary care physicians, this research has demonstrated that guidelines aimed at enhancing specialist directed referrals can lead to improvements in their performance. Nonetheless, translating guidelines into practice is a recognised issue, often requiring time and multiple exposures. Active forms of medical education and multifaceted interventions have been demonstrated to be the most effective means of implementing guidelines into practice, an approach that could further address referral inadequacies in the future.