Patterns of referral among internists in private practice are examined in terms of the rewards and costs perceived by physicians occupying different levels of professional status in the medical community. Referral patterns are highly related to professional status networks. High status internists showed the most cohesive patterns of referral and low status the least. Findings pertaining to the institutionalization of reciprocity, as well as the influence of social friendships, distance between offices, and hospital appointments are discussed. Policy implications and areas for further research are suggested.
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