I saw a specialist before being assigned a new primary care physician(whose work touches on the specialist’s field). The new primary care physician seemed like he may disagree with the specialist. Is it possible that he could prevent me from having ongoing access to that specialist?

I have only dealt with PPOs and FSAs and HDHPs and HSAs before, never HMOs, but I am temporarily covered by an HMO(not the long-term goal, but that's how it is now). My goal would be to move back to a plan where I could just deal with the specialist, but that's not the situation I am dealing with at the moment.

I am concerned that if the PCP disagrees with the specialist he may act in some way to prevent me from having access to the specialist.

When I went to the specialist the first tme, the specialist indicated that they needed a referral, and it's my understanding that referrals are limited in some way, like by time or by number of visits, and then they need to be renewed? Am I correct in that, or is that an incorrect understanding?

Basically, I am just concerned that if the PCP wanted to go a different way with my treatment he could say that's what he wanted, and then I wouldn't have access to the specialist I had seen previously for the issue, effectively just vetoing my ability to continue working with the specialist. Is that the case, or do I have a misunderstanding in the way that this system works?

submitted by /u/theedgeofoblivious
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See also  Quality Measurement of German Hospitals