Being Referred to Multiple Doctors

What is the legality behind referring specialist or other doctors?

Someone I know was initially diagnosed by doctor A who got my friend tested and got results. Doctor A then referred her to a specialist Doctor B who after consulting was now referred to Doctor C because Doctor B treatment isn't suited. All this referring incurring expensive out of pocket consultation fees. It feels very off and there's a lack of transparency.

Isn't Doctor A supposed to correctly assess the diagnostic and refer correctly to the correct specialist?

Comments

  • Medicine is highly specialised. If you want to be treated by someone who is an expert in the area, best to seek the right specialist. You can go public if you prefer (ie hospital clinics or places that bulk bill) which are free if you don't mind waiting a bit.

    • in theory you can go public, but when you're in the private system it can be hard to work out how to transition back to public!

      • That part should be easy - see your GP and ask them to write a referral to the public system, including a summary of what’s happened so far

  • Legality?

    There is no "law" regarding a doctor referring you to another in the context of your question.

    Depending on your circumstance, you may have an issue that is difficult to treat, highly specialised, etc. Even in relatively "straight forward" case, there may be many specialist doctors involved. I'm aware of someone who for what is effectively a "single issue" is/has been under the care of their GP and three separate specialists who work in concert to achieve an outcome.

    That said, if you are unhappy with the service being provided by your referring doctor (presumably a GP), you are of course able to take your business elsewhere, or at least get a second opinion.

  • Doctor A is likely a GP who are general practitioners. They will refer to who they think is best-suited, but as mentioned above, medicine is very specialised, e.g. you might have a complex upper respiratory condition that was referred to an ENT who then bumps it to an immunologist, etc., or if there's a structural cause, then a surgeon will likely be involved, plus any radiographers for imaging, plus other allied health, etc. This is not unusual. If you're cost-constrained and can wait, then go public.

  • As the old saying goes….

    "A specialist is someone who knows more and more about less and less"

    If Dr B is saying they are not suited to deal with the problem then your friend should heed that advice and go with someone else.

    I'm sure your friend doesn't want to be treated by someone who has pretty much out right told them that the problem at hand isn't their area of expertise

  • Shop around for Dr A… through the years, i noticed it s really hard to havea good Gp who has a good knowledge . Once you find the right Dr A. It will be less trip there,less out of pocket expense. I usually prefer gp who graduate in australia than the one from overseas .

    • I agree with this except with the overseas part it depends how long they’ve been working in a particular clinic or region. If someone is new to an area they will struggle to know which services or specialists to refer to even if they are Australian trained. The young ones who have trained in the local public hospital/health service recently or people who’ve worked in a region for a long time (irrespective of if they are overseas trained) seem to be best at this.

      • I tried many drs . Especially when i got my first born and went to a gp who was in the area for more than 20 years. She refers me to a pediatrician she knows really well who end up telling me that all babies cry and i should stop being dramatic. He cost me $350 just for telling me this!!! I wasn t happy with that. Decided to try alternatives medecines. Brought my baby to an osteopath who didn t hold his word and told me to change my gp asap !! Because what my daughter need was a pediatrician who knows better as she need to be on medication! And not him! Follow his advice, went for a new gp who graduated here. He listens to my concerns and referred me to a young pediatrician who graduated here also after i told him what the pediatrician told me and i need a second advice. That was a life saving! The second pediatrician ended up running the proper test and told me that while all babies cry it s often because something is bothering them. Cost me only $180 this time. And a good follow up . The unusual cries stop and my baby start putting on weight… Since then , i ll stick to gps graduating here when i move in a new area. And so far my referral have been really low in cost as the specialists know what to look for ..

  • What are the injuries?

    I've been in a situation where the was adamant to refer me to someone that turned out to be his brother who when I called and asked the hard questions - the brother couldnt help me.

  • If your friend is unhappy with the care received by any of the specialists they can call their office and let them know why and ask for their gap to be refunded. It’s probably a bit awkward, but I think most specialists won’t be too worried about the gap, and it might be helpful for them to have the feedback. It’s probably more a pain as they’ll have to cancel one transaction with Medicare then bulk bill another.

    If doc A is the GP it’s probably worth going back and letting them know what has happened, as they are meant to coordinate the care. After letting the various docs know that they are dissatisfied, if they aren’t happy with the response, there is a agency in each state for healthcare complaints https://www.ahpra.gov.au/Notifications/Further-information/H...

    It sounds like a good gp is the priority for your friend.

  • This happens a lot when the symptoms are considered psychosomatic, no one wants to deal with it.
    There is an unbelievable amount of people in the health system using phenomenal resources with nothing physically wrong with them.

  • the nievity of your question warms my heart

    welcome to our health system

    what can you do?

    be grateful if doctor c pans out and she doesn't waste even more money and time on even more doctors

    or

    if she can't cope with even this amount of cost she'll have to go public instead

    that's her 2 options;

    private - spend heaps of money and time, have the ability to switch drs if/when they are assholes, hypothetically get seen sooner in the first place but not necessarily, supposedly see 'better' drs but not necessarily

    public - spend much less money and much more time, potentially get stuck with (profanity) drs, hypothetically wait a long time to get started, possibly see the 'better' drs for free in their 'charitable' hours

    isn't it wonderful

    tldr: she'll never see those dollars again

  • The biggest problem I see here is that your friend allegedly doesn't know the reason why she's been referred to other doctors. That should be very clear, but communication between doctors and patients in Australia is usually not great. There is no problem with the referrals, many scenarios are possible. For example:

    Scenario 1:

    Doctor A (GP) diagnosed and referred your friend to a psychiatrist (doctor B).
    The psychiatrist saw your friend, reviewed history, diagnosis and previous treatments, and found that it was better if your friend saw a specialist in eating disorders (doctor C).

    Scenario 2:

    GP (A) diagnosed and referred your friend to a rheumatologist (B). Rheumatologist reviewed history, diagnosis and previous treatments, and found that it was better if your friend saw a specialist in Lupus (doctor C).

    It is annoying having to pay the out of pocket fees, but that's a problem with the system (public and private), not with the doctors.

  • What is the legality behind referring specialist or other doctors?

    There's no question of "illegality". The doctor is allowed refer to whoever they think is best suited to care for the patient.

    As long as the doctor didn't do anything blatantly incompetent (such as referring the patient to an eye specialist, when the patient complained about back pain) then there is nothing you can do about it.

    Note that there is no requirement for the patient to actually consult the specialist to whom they have been referred. They can choose not to visit the specialist, or to ask the GP to refer to some other specialist, or go to another GP for a second opinion.

    It feels very off and there's a lack of transparency.

    The doctor gives the patient the referral letter. The patient can read the letter and see the condition for which they have been referred and any attached test results. What more transparency do you want ?

  • When a specialist refers you to another specialist, don't mess around. They're referring you because your condition is beyond their scope of treatment and would rather you get treated by a dedicated expert.

    Usually, to get seen by some of the big specialised doctors, you need to be referred by other specialists. They don't generally take referrals from an ordinary GP because the GP knows about as much as anyone with access to Google does.