It seems that patients can just book appointments with specialists without seeing a GP. Is that right?
To give my context, I'm a GP in Australia and in our system a patient sees a GP first then if the GP feels it's required/appropriate or if they cannot diagnose or manage the problem they refer on to an appropriate specilist.
The reason for this is partly beurocratic and partly practical.
The beurocratic reason is that our (universal) healthcare system only pays for specialist doctor appointments if a referral has been made by a go in the past 2 months or another specialist in the past 6 months. It's intended as a way to make sure the care is still required. Obviously there are some obvious flaws in that and to be honest I don't disagree
The practical reason is to not burden specialists with medical issues not requiring their "higher" skill sets. Ie. If every case of food poisoning was reviewed by a gastroenterologist they would never get anything else done.
Technically people can see specialists without referrals but they have to pay for everything out of pocket. And most specialist refuse to see such people...usually because they're some manner of crackpot.
It's obviously not a perfect system but I think it does ballance the positives and negatives of either situation quite well.
So how exactly does it work in the USA, specifically; Is it really as simple as calling a specialists office and booking an appointment? How does insurance play into that? (Hopefully that's not too bigger a can of worms) How do you know what specialist you need if your not a doctor? IE is my back pain orthopedics or neurosurgical? Do women really see gynocologists once a year for cervical screening and to write scripts for the pill? Surely that's a waste of their time. What are GPs for then in the American system? In Australia GPs do cervical screening and pill scripts.
Thanks in advance.
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