Why would a referral be required?

[Chris]

Besides insurance requiring it, the referral process usually includes your PCP sending medical records to the specialist.

[pjohns]

If you think you have skin cancer then you wait 6 months for appointment

If one does, indeed, have skin cancer, couldn't that have metastasized badly within the course of six months--putting the potential patient's life in severe jeopardy?

[pjohns]

It depends on what type of insurance you have. HMOs operate through your primary care provider. They give you referrals for specialists.

POP insurance doesn't work that way. You can go to any doc in your network. These plans cost more and if you go outside your network you pay much more and maybe 100%.

I have a PPO. (Specifically, it is Federal Blue Cross/Blue Shield.)

[pjohns]

Many people don't bother with annual checkups anymore.

I have a semi-annual checkup, plus an annual followup. (I have still not figured out the purpose of the latter.)

[XavierOnassis]

I have a MedicareAdvantage plan and it is far better than any insurance I ever got from employers. The university where I worked would change plans every two or three years, and every new plan would have a higher premium and a higher co-pay. I print everything on forms very legibly, but three times, the university plan would fail to pay for blood tests and such and the first thing I would learn about it was a nasty letter from some collection agency. They claimed each time that the problem was the wrong social security number, blaming me.

[carolina73]

If one does, indeed, have skin cancer, couldn't that have metastasized badly within the course of six months--putting the potential patient's life in severe jeopardy?

So true. But it doesn't matter.
We live at the beach in the South. Everyone spends a lot of time in the sun.
We are also a retirement area.

The two combined create more demand than they can handle.

[donttread]

I am still trying to figure out just why a specialist--a doctor--might require a referral from a PCP (unless one is already an established customer with that specialist).

That makes absolutely no sense to me.

Any thoughts on the matter?

Probably a requirement of your insurance.

[Peter1469]

If one does, indeed, have skin cancer, couldn't that have metastasized badly within the course of six months--putting the potential patient's life in severe jeopardy?

Depends on what type of skin cancer.

[slideman]

Depends on what type of skin cancer.

My wife had a basal cell carcinoma and they wanted to do a Mohs procedure. This is a deal where they scrape off and examine successive layers of the cancer until they're sure they've got it all.
She tried something called the Black salve which I had never heard of before.
It wasn't a pretty scene but it burned out the cancer. I was skeptical until I saw the result.
Live and learn

[Peter1469]

My wife had a basal cell carcinoma and they wanted to do a Mohs procedure. This is a deal where they scrape off and examine successive layers of the cancer until they're sure they've got it all.
She tried something called the Black salve which I had never heard of before.
It wasn't a pretty scene but it burned out the cancer. I was skeptical until I saw the result.
Live and learn

I have had the Mohs several times. And also whatever came before that.