mtomaino
05-17-2010, 12:53 PM
When you are referred to a Specialist, it usually reflects a referral pattern based on a number of factors. These might relate to competency--specialized expertise, focus, and experience, or more pragmatic issues such as availability and a track record of patients speaking highly of the care they have received in the past. Frequently it may be "by default"-----this is where your doctor always sends his/her patients.
Most important is that you are receiving the care you need and deserve--by the Specialist. Just remember--"Your Shoulder (hand and elbow too). Your Choice."
In this region, you do not need a referral unless you have a Medicare Blue Choice product. This means that you can refer yourself to a Specialist of your choosing. At the very least, you can be an active participant in your care as opposed to being passively sent to a provider.
I am not suggesting that your Doctor is in anyway remiss by sending you where he/she sends you. What I am advocating is that you--on the receiving end of the referral--receive the best and most appropriate care, and actively participate it the assessment thereof.
I am increasingly disturbed by patients with shoulder pain who have been referred to large multispecialty orthopaedic practices, only to be seen by a nonspecialist or physician's assistant. This typically results because access in the appropriate Specialist's office is limited. To address this limited capacity, practices are starting to "capture" the referral by utilizing urgent-care providers. Too frequently this delays the most appropriate care or intervention---until the Specialist actually sees the patient.
Equally as disturbing is when a patient is dismissed, effectively, because they have a strange complaint or when it seems as though their condition will not require surgery. In these cases, they may never actually see the Specialist.
Would you think it interesting if you discovered that your Doctor may be informally told that you need to be referred to another doctor within "System"? Indeed, as Hospital System's employed primary care physicians are the gateway to driving that system's utilization, referrals outside the network are discouraged.
So---be empowered regarding who you are sent to for Specialty care. Visit websites; talk to friends. Reachout and make sure you are receiving the care you deserve.
"Your Shoulder. Your Choice".
Most important is that you are receiving the care you need and deserve--by the Specialist. Just remember--"Your Shoulder (hand and elbow too). Your Choice."
In this region, you do not need a referral unless you have a Medicare Blue Choice product. This means that you can refer yourself to a Specialist of your choosing. At the very least, you can be an active participant in your care as opposed to being passively sent to a provider.
I am not suggesting that your Doctor is in anyway remiss by sending you where he/she sends you. What I am advocating is that you--on the receiving end of the referral--receive the best and most appropriate care, and actively participate it the assessment thereof.
I am increasingly disturbed by patients with shoulder pain who have been referred to large multispecialty orthopaedic practices, only to be seen by a nonspecialist or physician's assistant. This typically results because access in the appropriate Specialist's office is limited. To address this limited capacity, practices are starting to "capture" the referral by utilizing urgent-care providers. Too frequently this delays the most appropriate care or intervention---until the Specialist actually sees the patient.
Equally as disturbing is when a patient is dismissed, effectively, because they have a strange complaint or when it seems as though their condition will not require surgery. In these cases, they may never actually see the Specialist.
Would you think it interesting if you discovered that your Doctor may be informally told that you need to be referred to another doctor within "System"? Indeed, as Hospital System's employed primary care physicians are the gateway to driving that system's utilization, referrals outside the network are discouraged.
So---be empowered regarding who you are sent to for Specialty care. Visit websites; talk to friends. Reachout and make sure you are receiving the care you deserve.
"Your Shoulder. Your Choice".