RT Journal Article SR Electronic T1 Physician practices in referring rheumatoid hand and thumb carpometacarpal arthritis cases to hand surgeons JF Saudi Medical Journal JO Saudi Med J FD Prince Sultan Military Medical City SP 919 OP 928 DO 10.15537/smj.2024.45.9.20240187 VO 45 IS 9 A1 Fadel, Zahir T. A1 Jefri, Zainalabden E. A1 Alkhalifah, Hussain A. A1 Ahmad, Hanin M. Y. A1 Alzahrani, Raghad A. A1 Ashi, Mohammed B. A1 Samargandi, Osama A. YR 2024 UL http://smj.org.sa/content/45/9/919.abstract AB Objectives: To investigate the referral practices across different medical specialties and identify possible barriers to hand surgery referral. Rheumatoid hand deformities (RHDs) and thumb carpometacarpal (CMC) arthritis may require surgery once deformities occur. However, in Saudi Arabia, the rate of referrals to hand surgeons remains low.Methods: This was a cross-sectional study that included 102 consultants of family medicine, rheumatology, and orthopedics across various regions of Saudi Arabia. A total of 30 institutions were contacted and requested to distribute a survey questionnaire to their physicians; these institutions included 8 private hospitals, 16 government hospitals, and 6 primary healthcare centers. The survey included questions on the incidence, rate, management, knowledge, and referral of patients with RHD and CMC arthritis using a 5-point Likert scale. The Kruskal-Wallis H test was utilized in our analysis to evaluate the differences in responses among the 3 specialties.Results: For RHD and thumb CMC arthritis, the referral rate was higher among orthopedic surgeons compared to rheumatologists and family medicine physicians. The main barriers to referral were patient refusal, medical treatment alone being deemed adequate, and a lack of awareness of surgical options for management.Conclusion: Our findings highlight discrepancies in patterns of physician referral of RHD and thumb CMC arthritis cases to hand surgeons, indicating the need for targeted interventions to improve referral rates and enhance patient outcomes.