Abstract
Long wait times, inefficient care coordination, and patient disengagement have been identified as significant issues in Canadian specialist care (Liddy et al. 2018). This lack of patient engagement could be attributed to the common belief that patients do not have the right expertise (Baker et al. 2016; Brekke, Nuscheler, and Straume 2007, 18), which seems to be enshrined in the gatekeeping role that Canadian general practitioners (GPs) routinely play when referring patients to specialists (Forrest 2003). Whatever the origins and intents of deploying GPs to control access to specialists, poor performance in the GP to specialist (G2S) pathway not only delays treatment and care (Liddy et al. 2018), but it can also cause unnecessary harms (i.e., pain, stress) to patients (McCarron et al. 2019; Manafo et al. 2018). Indeed, poor transitions between GPs and specialists can lead to negative health outcomes (Yiu et al. 2015, 24), especially when patients face repeated, but necessary, transitions between HCPs throughout their care.
