[biker1]

Dermatologist are different, as I already indicated. Once you have a relationship with a specialist for ongoing care you certainly don’t need to go through your PCP. I assumed this was fairly obvious. The only other piece of information you have communicated is that you need to find a better PCP. Also, all of my interactions with my PCP do not involve a $300 office visit as I have asked her about issues over their portal and received advice on who to see. I am pretty sure my PCP know more about health care than I do and it would be stupid not to take advantage of her knowledge.

Originally Posted by Blueblaze

Well, that's an easy one to answer. I didn't need to ask my PCP's permission (or route him $300 of my insurer's money) when I needed to see a urologist for a prostate problem that I knew the PCP could do nothing about. Heck, my PCP refuses to even do prostate exams, or for that matter, the skin cancer screening that I've had to pay a dermatologist for every year since I moved to Florida. Would you waste time scheduling your PCP if you suddenly noticed a mole turn threatening, if you didn't have to? I wouldn't.

Two years, ago, I was due for my 5 year treadmill stress test, that my Texas doctor used to do in his office, as part of my physical, when it was due. Here, I had to pay a cardiologist. So I certainly would not waste time talking to my primary if I thought I actually had a heart problem. And I certainly didn't waste time consulting my PCP before I saw a podiatrist for my plantar faciistus last year.

Referrals are generally a complete waste of time and money, but if I want one, I'm free to get one with my PPO. It's just my call instead of the doctor.