REFERRAL OF A PATIENT from one physician to another for consultative advice or continuing care has long been an essential part of medical practice. Yet its present mechanism is often incomplete and needlessly inefficient. What little has been written of inadequacies in the referral process comes mainly from university public clinics, recently summarized by Williams and his associates.1In their study of one such medical center, numerous problems were identified. In particular, the patient often arrived at the clinic without information as to the specific reason for referral or regarding past findings and therapy. Methods.— This appraisal of referral practices is based on the experience of one consulting physician (a neurologist) at a university hospital in the Southeast. The data were collected from 100 consecutive private patients each of whom had recently been under the care of a physician in the home community and was referred by him. Forty