When They Won’t Let You Refer to Who You Want


Physicians used to be able to refer to who would best take care of their patients, that's changing.

Referrals are the lifeblood of any physician practice.

It makes it hard to practice when you don’t have any patients.

For those in private practice, this means getting out into the community, making relationships with other physicians, and showing them that the patients that they refer to you are in good hands, and that you care.

This also means keeping good communication and being appreciative. Ending an email or note with “Thank you for your referral” has been commonplace for a very long time.

That is how it used to work, or sort of works.

For those physicians that are still self employed that is exactly how it works.

However, with 70% of physicians now working for hospital conglomerates, the situation is different. A retired orthopod I know told me that he had primary care docs referring to him for over 20 years, that suddenly stopped once the practice was bought out by the hospital system. A lot of referrals start from the PCP, and hospitals love to buy PCP practice not because they are super profitable, but because they want the patients referrals into their system.

They are essentially trying to “buy the patients”. Can physicians and providers still refer to outside of the network? Legally yes, practically not really.

These systems make it technically difficult to refer out, and those providers are encouraged not to do it.

I know another fellow general orthopod who wanted to refer his patients to a master spine surgeon he trained with, but was told not to by hospital management because the spine surgeon was in a different hospital network.

How this doesn’t violate Stark law, I don’t know.

While this may not seem like a huge deal, it is a small piece of the pie that contributes to physician loss of autonomy and worsening healthcare for our patients.

Want to refer to that great specialist down the street who you know is very good and cares? Sorry, you can’t, he isn’t part of our system.

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