There are many interested parties who try to influence our clinical activities. Sometimes it is Big Pharma, with the latest and ‘easiest ever to use’ inhaler device, or the government, with their Orwellian letters that attempt to realign statistical outliers into single file.

However, our biggest influencer is the patient sat across from us.

And this is never more true than when it comes to whom we refer our patients.

Now, of course, when I decide to whom to refer a patient, I have a checklist of prerequisites that take account of my pet peeves, especially around accessibility and communication.