[patrickg_zill]

That is very accurate... I had an injury that I knew required specific surgery, but when I called the surgeon's office to make an appointment I was told that they only accepted referrals from family doctors, that is, I had to pay to visit a family doctor first.

This applies nowadays to most specialists as well.

[ceejayoz]

That's a pretty reasonable filter to have. Sure, there'll be some cases like yours where you've got enough knowledge to request a specific surgery, but for every one of those there's likely to be several "your back pain is caused by weight and posture, surgery isn't indicated" (and the occasional "why don't we see a psychiatrist about that radio the CIA put in your brain instead of a neurosurgeon...") that the GP can winnow out at a quarter of the cost and without tying up an already in-demand specialist.

[SkyPuncher]

I don't really consider this a problem.

Specialists are packed to the gills already and very expensive. Specialists don't want to spend time with patients who don't actually need specialized care and insurance doesn't want to pay specialists without first qualifying the issue.

[patrickg_zill]

I agree; however the first thing he did was to order a CT scan to confirm the diagnosis and get the exact location. So the family doctor visit was thus duplicative.

[Broken_Hippo]

Confirming the diagnosis might or might not be prudent, depending on the injury and how likely false positives are in those sorts of injuries. Confirming the exact location shortly before the surgery? That might be prudent, especially if the damage was likely to move a bit or become worse during the waiting time. This should have been explained better.

Otherwise, I'd agree that the test was unnecessary and shouldn't be done a second time. Weirdly, it could have asily been that the first test wasn't in his particular working network - I've seen this done in hospitals before (redoing tests from places not in the hospital's network). This still isn't an issue with the referral system, though, but points to other problems.

[imglorp]

I hope the specialist didn't get a kickback from the imaging company

[ryandrake]

The US healthcare system is a raging river of money, and you can bet that every doctor, lab, hospital and other medical service has their buckets dipped into it. The entire system seems to be set up to squeeze as many billable office visits out of you as possible.

[FireBeyond]

In some parts of the US, I'd be surprised if the specialist didn't own at least a share of the imaging company.

[LorenPechtel]

In general I think it's a good idea. However, once someone has an ongoing medical issue that requires a certain type of specialist that gate should be left open. Keeping having to go back to your primary just to get back to the specialist you actually need is wasteful.

[Gatsky]

This a feature, not a bug.