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Clinical · Prescriber conversations

Coming back to: Getting a referral rather than a refusal

Solved
Solved by n.kaufmann in post #8
On post #7 — agreed on the reasoning, with one qualification. The most useful thing anyone has posted about Getting a referral in this category was a table of what had been measured and by whom. That is what I would want again.

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BN
b.nwosuTL224 May 2025#1

Posting this under the heading it deserves: Getting a referral rather than a refusal Everything below is what sits behind that.

Working notes on Getting a referral rather than a conclusion. I would rather post the reasoning while it can still be corrected than post the answer once I am committed to it.

Everything below is checkable. Where I have taken a figure from somewhere else I have said where; where I have estimated, I have said that too.

0 likes 14mo
TV
t.vargaTL224 May 2025#2

If you have been doing something the prescriber does not know about, saying so is more useful than not. Clinicians here consistently say they would rather know.

I would be interested in a counterexample if anyone has one.

1 like 14mo
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NardoneTL2Member25 May 2025 · edited#3

Two claims get bundled together under Getting a referral and they need separating. The descriptive one — this is what was observed — is usually well supported. The causal one — this is why — usually is not.

Almost every disagreement in threads like this one dissolves once you say which of the two you are making.

11 likes 14mo
LV
l.vermeulenTL226 May 2025#4

A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.

25 likes 14mo
MM
methods_marginTL3Regular26 May 2025#5
Nardone, post #3: Two claims get bundled together under Getting a referral and they need separating. The descriptive one — this is what was observed — is usually well supported. The causal one — this is why — usually is not. Almost every disagreement in threads like this one dissolves once you say which of the two you are making. Go to post

I would rather this thread reach "we do not know" about Getting a referral than reach a confident answer that nobody can support when asked.

0 likes in reply to #3 14mo
SC
s.chowdhuryTL3Regular26 May 2025#6
l.vermeulen, post #4: A question phrased as "what would you want to see before considering X" is answerable and is not a request for X. Go to post

Agreed, and I will stop repeating the version of this I had been repeating.

4 likes in reply to #4 14mo
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IRenaudinTL2Member27 May 2025#7

Asking what would change the plan is more productive than asking whether the plan is right. It gets you the decision criteria rather than a verdict.

17 likes 14mo
NK
n.kaufmannTL2 Solution27 May 2025#8

On post #7 — agreed on the reasoning, with one qualification.

The most useful thing anyone has posted about Getting a referral in this category was a table of what had been measured and by whom. That is what I would want again.

33 likes 14mo
OA
o.abrahamsenTL3Regular28 May 2025#9

For anyone finding this later: the short answer on Getting a referral is that it depends on one thing, and the rest of the thread is people identifying which thing.

26 likes 14mo
HR
h.ramosTL228 May 2025#10
n.kaufmann, post #8: On post #7 — agreed on the reasoning, with one qualification. The most useful thing anyone has posted about Getting a referral in this category was a table of what had been measured and by whom. That is what I would want again. Go to post

Answering the question post #7 raises rather than the one it answers.

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

0 likes in reply to #8 14mo
KC
k.chukwuTL228 May 2025 · edited#11

Getting a referral is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with boring.

2 likes 14mo
AT
apostille_traceTL1Member29 May 2025#12

Taking post #9 at face value and following it one step further.

Nothing here is medical advice, and this subcategory exists to help people ask better questions rather than to answer them.

That has held every time I have looked, which is not the same as always.

0 likes 14mo
CF
c.falkTL229 May 2025#13

Prescription logistics: confirm whether it will be filled locally, requires mail order, or will be prescribed off-label and needs a compounding pharmacy. Different paths have different implications.

28 likes 14mo
SE
septum_entryTL2Member30 May 2025#14
h.ramos, post #10: Answering the question post #7 raises rather than the one it answers. Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation. Go to post

Adding a small correction to the Getting a referral summary above rather than a disagreement with it. The substance holds; one of the figures is out by a factor that matters.

13 likes in reply to #10 14mo
FL
f.laurentTL230 May 2025#15

Grateful for the specificity. Vague answers to this question are what sent me looking.

5 likes 14mo
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LundqvistTL2Member30 May 2025#16

This follows post #13 rather than contradicting it.

On Getting a referral, I would rather understate and be corrected upward than overstate and be quoted. That is a house style here and it is a good one.

0 likes 14mo
JS
j.solbergTL231 May 2025#17
b.nwosu, post #1: Posting this under the heading it deserves: Getting a referral rather than a refusal Everything below is what sits behind that. Working notes on Getting a referral rather than a conclusion. I would rather post the reasoning while it can still be corrected than post the answer once I am committed to it. Everything below is checkable.… Go to post

A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.

0 likes in reply to #1 14mo
KB
k.bettencourtTL2Member31 May 2025#18
septum_entry, post #14: Adding a small correction to the Getting a referral summary above rather than a disagreement with it. The substance holds; one of the figures is out by a factor that matters. Go to post

The version of Getting a referral that I was taught turned out to be a teaching simplification. Useful, and not true in the way I had assumed it was.

19 likes in reply to #14 14mo
TB
t.brandtTL231 May 2025#19

Where I part company with post #17, and it is a narrow parting.

On Getting a referral the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that.

0 likes 14mo
TW
t.waldenstrmTL2Member1 Jun 2025#20
IRenaudin, post #7: Asking what would change the plan is more productive than asking whether the plan is right. It gets you the decision criteria rather than a verdict. Go to post

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

29 likes in reply to #7 14mo
AP
a.pereiraTL21 Jun 2025#21

The practical version of Getting a referral is three sentences long. The rigorous version is three pages and reaches the same conclusion with the conditions attached.

0 likes 14mo
FP
forest_plotTL3Evidence synthesis1 Jun 2025#22
a.pereira, post #21: The practical version of Getting a referral is three sentences long. The rigorous version is three pages and reaches the same conclusion with the conditions attached. Go to post

A question phrased as "what would you want to see before considering X" is answerable and is not a request for X.

Not disagreeing with anyone above, just adding the bit I keep having to look up.

5 likes in reply to #21 14mo
HB
h.bakkerTL22 Jun 2025#23

Confirming post #22 from a second method, which matters more than confirming it from a second person.

Getting a referral looks different depending on whether you are reading the primary literature or the summaries of it, and the difference is not in our favour.

20 likes 14mo
PE
ppm_errorTL3Analytical chemist2 Jun 2025 · edited#24

Following, with nothing to contribute beyond having asked the same thing elsewhere.

0 likes 14mo
RL
r.lundgrenTL22 Jun 2025#25

Prescription logistics: confirm whether it will be filled locally, requires mail order, or will be prescribed off-label and needs a compounding pharmacy. Different paths have different implications.

I have kept the units in throughout, for the obvious reason.

2 likes 14mo
DM
d.moreauTL2Regular3 Jun 2025#26
t.varga, post #2: If you have been doing something the prescriber does not know about, saying so is more useful than not. Clinicians here consistently say they would rather know. I would be interested in a counterexample if anyone has one. Go to post

Answering the question post #25 raises rather than the one it answers.

Careful with the language on Getting a referral. "Not detected" and "not present" are different findings and the first is a statement about the method.

9 likes in reply to #2 14mo
NC
n.cardosoTL23 Jun 2025#27
k.chukwu, post #11: Getting a referral is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with boring. Go to post

Post #26 is the version of this I will quote in future. One addition.

Bringing a published document rather than a summary changes the conversation. Bringing a forum thread does not.

Adding a source would improve this post and I do not have one to hand.

28 likes in reply to #11 14mo
OL
o.lindgrenTL2Regular3 Jun 2025#28

I would keep Getting a referral and the decision it usually gets used for separate in this thread. They are related and they are not the same question, and merging them is why the last one went badly.

0 likes 14mo
MA
m.almeidaTL23 Jun 2025#29

Narrowing post #26, because the general version has more than one answer.

What I want from this Getting a referral thread is the list of things that would need to be true for the claim to hold. If we can write that list, we can check it.

5 likes 14mo
KB
k.brandl_deTL3Translator · DE4 Jun 2025#30

Bringing a record of symptoms with dates and severities makes an assessment materially easier and is the single most useful preparation.

14 likes 14mo