thanks for your comments Bob. It's nice to know you try hard to get back to the PCP, and good feedback for those of us in primary care.
We have an office policy whereby the patient must have been seen by me for a particular problem in order to get a referral. For example the patient needs a referral for breast reduction surgery, we could easily just call the plastic surgeon's office and make this referral. However we make them come in. The patient may balk saying "I was just in for an annual physical, why do I have to come back?" My staff tells them that the specialist will not see them without a letter of referral and we require that you see our doctor in order to get a referral letter. I talk to the patient, document the reason for referral in an office note, and generate a letter with AC. The specialist has the med list, problem list, and some documentation as to the reason for consultation. The patient while initially balking at the need to come in, is relieved to know their referral is happening. The specialist has the information they need, the patient has what they need, and I got to bill an office visit and thus don't feel like we are being abused by our patients so I'm happy. Win, win, win.
I also take patients selectively in consultation for Osteopathic Manipulation Treatments. I find it equally annoying, like you, when there is little to no information sent by the referring office. The classic terrible referral is when I get only a computerized phone message from their office stating "patient called for referral to Dr. Lauer for back pain, referral processed." I don't take that referral. But I have my own family medicine practice which keeps me very busy, so I don't have to take all referrals requested of me.
