This retrospective study of referral patterns in an individual private practice demonstrates that the family physician provides a definitive care for the large majority of patient problems in everyday practice and does not function primarily as a triage officer. Ninety-seven percent of all patient contacts, both ambulatory and in-hospital, were managed by the individual physician and his staff. Two-and-one-half percent of patient contacts required consultation with local specialists, and only .5 percent required referral to a tertiary care center. These results are compared with other large-scale population studies of the "ecology" of medical care and with other recent studies of referral patterns in family practice.