5. A multispecialty group has looked at its revenue stream in recent years. In doing so, the group has recognized that the revenue has been flat and even seen some decline.

This led to an analysis of the referral pattern of the primary care physicians to the specialty departments within the group. The following table shows the results of this analysis:

At the physicians’ monthly meeting, these data were presented on a slide. The head of the orthopedics section turned to the head of the primary care section and said, “Your physicians must refer to us. We must pass a rule to make this mandatory.” No one said anything, but there was uncomfortable shuffling around the table. The nonphysician staff members in attendance were uncomfortable. After the meeting ended, the administrator of the group called you in as the marketing director along with the chief financial officer and asked for your perspective on these data.

Provide your perspective.

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Internal 2017 2018 2019 Referrals (%) (%) (%) Orthopedics 86 83 76 Urology 96 95 88 Gastroenterology 97 87 91 Neurology 89 90 80