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How Primary Care Providers Give Better Referrals

Healthy Living

When it comes to seeing a specialist, patients have two options: make an appointment with a specialist who will see them without a referral or receive a referral from their primary care provider (PCP). While most health plans do not require patients to get a referral from their PCP in order to receive specialist care, getting a referral from a PCP is generally within the patients’ best clinical and financial interests. Here’s how:

Provides guidance through the health care system. As a generalist practitioner, your PCP has a lot of insight into what your symptoms may be communicating, as well as an understanding of your medical history. This knowledge makes them an ideal place to start when you’re experiencing health issues. Your PCP will be able to guide you to the correct specialist or specialists so that you don’t have to rely on your own guesswork.

Prevents costly mistakes. The expert opinion of a specialist is valuable—and it comes at a cost. A self-referring patient is in the risky position of self-diagnosing, which can result in a visit to the wrong specialist or an unnecessary visit when a condition could have actually been treated by a PCP. By seeing a PCP first, patients can ensure they’re getting the right treatment and referral when needed.

Helps patients make the best decision. As deductibles continue to rise, patients are more accountable for the cost of their health care treatment. And as patients continue to expect value-based care, PCPs are more accountable for helping patients keep costs low while ensuring they receive the best care possible. An ongoing, close relationship with a PCP is increasingly valuable, as a PCP is truly in a position to help patients make the best decisions clinically and financially.

Choosing a primary care provider is one of the most important health care decisions you’ll make. Developing an ongoing, trusting relationship with a provider you like leads to better health care outcomes. MyHealthKC makes it easier than ever to find the right primary care provider for you. Just answer a few questions about yourself, and our scientific algorithm will match you with local providers who are compatible with your personality and health care needs. Get started by taking the quiz.