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Thursday, 15 August 2019 11:39

Why do I need a referral to see the Specialist? Featured

Why do I need a referral to see the Specialist?

It seems such a hassle to get a referral before seeing a specialist. There’ s making an appointment to see your GP first, then the waiting to see them and then the cost of the visit to get the referral. And you still have all that to do for the specialist again!

What’s it all about? Why the red tape?

The truth is that you don’t have to have a referral to see a specialist but Medicare will not provide a rebate for your visit unless certain referral rules are met. Such rules are put in place by Medicare (essentially your insurer) and if you are to receive financial assistance for your specialist visit then both you and your GP need to follow them.

The most important of these rules are:

  1. Your referral must be dated either on or before the day you see the specialist. General Practitioners are not permitted to back date referrals. It is no good asking your GP for a referral after the event.
  2. The GP referral is valid for 12 months. A referral from one specialist to another is only valid for 3 months.
  3. The referral covers the assessment and ongoing management of a particular problem by the specialist.
  4. If over time, the specialist needs to continue to see you on an ongoing basis to manage a specific problem, an indefinite referral may be possible. In this case you would not need to see your GP yearly to have the referral renewed. Such indefinite referrals are issued at your GPs discretion taking into account Medicare regulations.

Leaving aside the Medicare regulations, having a GP refer you to a specialist is good medical practice. Advantages include:

  1. Your regular doctor and medical practice know your past medical history well and can communicate this to the specialist in the referral letter.
  2. A GP understands the wider medical context of their patient’s problems and has a network of specialists who they have used before. This puts them in a unique position to advise who is the best person to send you to. Sometimes recommendations of friends and families are not always suitable.
  3. It can be hard to know which type of specialist is appropriate for your problem. Again, you GP can assist here.
  4. Specialists vary in terms of how appointments are made, the wait time to see them and the cost of their services. Your GP will be familiar with all of these issues. In the case of urgent problems your GP is best placed to get timely access to a specialist opinion.
  5. Specialists are required to communicate, usually in writing, with your GP after they see you. This communication becomes part of your medical history, which is collated with all the other parts of you health story at your GP’s practice. This is an invaluable resource for you and any future health professional to have.

Although the referral may sometimes seem a waste of time, why not use it as an opportunity to have a general check on your health? If you have booked a standard appointment there is plenty of time to raise other concerns with your doctor. Sometimes what comes out of this ends up being more important in the long run than the referral itself.