title: Poor glycemic control as a reason for referral of diabetes patients to specialists in Israel.
abstract: OBJECTIVE
  Family physicians face the dilemma of when to refer patients with diabetes to specialists. This study examined attitudes of family physicians to referring patients with poor glucose control to diabetes specialists.
  
  
  METHODS
  At continuous medical education courses, family physicians were asked to respond anonymously, as to whether they generally manage the diabetes of their patients, and specifically those with poor glycemic control (HbA1c>9.0%).
  
  
  RESULTS
  Of 470 respondents, 426 (90%) reported that they generally manage their patients' diabetes; 202 (43%) reported that they manage the diabetes of patients with HbA1c>9.0%. Board certification in family medicine and affiliation to a health maintenance organization, but not sex, age, years of professional experience, or the proportion of patients with diabetes at their clinics, were associated with referral practices.
  
  
  CONCLUSIONS
  Family medicine residency and organizational support appear to promote treatment by family physicians of patients with poorly controlled diabetes in the primary care setting.
authors.affiliation: Department of Family Practice, Leumit Health Services, Tel Aviv-Yafo, Israel.|The Ruth & Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; yfogelman@gmail.com.
authors.forename: Yacov
authors.initials: Y
authors.lastname: Fogelman
authors.affiliation: The Ruth & Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.|Department of Family Medicine, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Khaled
authors.initials: K
authors.lastname: Karkabi
authors.affiliation: The Ruth & Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.|Department of Family Medicine, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Margalit
authors.initials: M
authors.lastname: Goldfracht
keywords: diabetes management; diabetes specialists; endocrinologists; family medicine; primary care