Comparative analysis of general practitiones/family doctors and therapists for their patients need in particular specialists consultation

Enhancing the accessibility of primary health care can be achieved through the development of general medical practice. The Moscow healthcare system is a notable example of this initiative, with a unique organizational model that simultaneously operates primary care physicians and general practitioners (GPs or family doctors). However, the professional status of these entities is regulated asymmetrically; a professional standard has been established for primary care physicians, while an analogous framework for GPs has remained in a project stage since 2018. This context necessitates a comparative analysis of the practical aspects of their medical roles, particularly regarding the need for patient consultations with specialist doctors, which holds both scientific and practical significance. Objective. To compare referral needs for consultations with second-level specialists among general practitioners (family doctors) and primary care physicians at a Moscow outpatient clinic. Materials and methods. A retrospective analysis was performed using data from the Unified Medical Information and Analytical System (UMIAS) for the year 2024 at a single city outpatient clinic. The study analyzed the number and structure of referrals made by 50 general practitioners and 110 primary care physicians. Analytical and statistical methods were employed to interpret the data. Results. The proportion of referrals from patient visits was 18.2% for general practitioners, compared with 16.7% for primary care physicians (p=0.018). Moreover, the average number of referrals per general practitioner was significantly higher (712 vs. 505, p<0.05). Notably, the most pronounced differences were observed in referrals to cardiologists and endocrinologists. Compared with 2019, the overall demand for specialist consultations has more than doubled across both physician groups. Conclusion. The findings indicate that the referral workload for general practitioners (family doctors) is statistically significantly higher than that of primary care physicians. The observed twofold increase in referral rates over the past five years aligns with the transition to a referral-based model for accessing specialists. These results suggest an improvement in coordination within primary care settings, despite the ongoing legal ambiguity stemming from the absence of an approved professional standard for general practitioners (family doctors). The necessity of rectifying this regulatory disparity for effective planning of primary health care resources is underscored.