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Do surgeons need a referral from your original surgeon in order to see you?

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  • Do surgeons need a referral from your original surgeon in order to see you?

    Does a surgeon have to have a referral from your original surgeon in order to see you ? I recently saw a surgeon and was told he could not help me without a referral to his clinic from my surgeon, and that I would have to actually request this from my surgeon. Has anyone else been told this or had to try and get this from their surgeon to be seen somewhere else?

  • #2
    I believe it depends on your health insurance policy. When I called my insurer to ask them about seeing a local surgeon and out of state surgeon, my plan does not require a primary doctor referral. In my policy, it is called "self-referral." When I scheduled the appointment with Dr. Lenke, his coordinator told me to be sure to bring my referral letter with me, but I explained that I have a "self-referral" plan. There was no issue when I checked in for the appointment.

    Warmly,
    Doreen
    44 years old at time of surgery, Atlanta GA

    Pre-Surgery Thorasic: 70 degrees, Pre-Surgery Lumbar: 68 degrees, lost 4 inches of height in 2011
    Post-Surgery curves ~10 degrees, regained 4 inches of height

    Posterior T3-sacrum & TLIF surgeries on Nov 28, 2011 with Dr. Lenke, St. Louis
    2 rods, 33 screws, 2 cages, 2 connectors, living a new life I never dreamed of!

    http://thebionicachronicles.blogspot.com/

    Comment


    • #3
      That's very strange. I've seen many surgeons, neurologists, general doctors, cardiologists just from researching on who is good near me, and I didn't have referrals and they were all fine. I even asked for many second opinions on surgeries, and it wasn't a problem. I think 1-2 asked me, who referred you and I just said general doctor. In your case, maybe just ask your surgeon to give you a referral, I don't see why he would mind.

      Comment


      • #4
        Originally posted by leannebr View Post
        Does a surgeon have to have a referral from your original surgeon in order to see you ? I recently saw a surgeon and was told he could not help me without a referral to his clinic from my surgeon, and that I would have to actually request this from my surgeon. Has anyone else been told this or had to try and get this from their surgeon to be seen somewhere else?
        I don't understand. He let you make an appointment, but won't agree to do surgery without a referral from your prior surgeon? That's just bizarre. At UCSF, patients usually have to jump through hoops to be seen by one of the surgeons.
        Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
        ---------------------------------------------------------------------------------------------------------------------------------------------------
        Surgery 2/10/93 A/P fusion T4-L3
        Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

        Comment


        • #5
          Originally posted by leannebr View Post
          Does a surgeon have to have a referral from your original surgeon in order to see you ? I recently saw a surgeon and was told he could not help me without a referral to his clinic from my surgeon, and that I would have to actually request this from my surgeon. Has anyone else been told this or had to try and get this from their surgeon to be seen somewhere else?
          I have seen several other surgeons and have never had to have a referral

          Melissa
          Melissa

          Fused from C2 - sacrum 7/2011

          April 21, 2020- another broken rod surgery

          Comment


          • #6
            A year ago+ I tried to get an appointment at this clinic for a second opinion on having my scoli surgery. They said it was year long wait.
            A few weeks a ago I got a letter appointment in the mail and realized it was probably from a year ago and wondered if the Dr would still see me. I have been having so many problems and really need help. I've actually been praying for a long time to be able to go to this clinic even without insurance coverage since my surgery. I wrote a letter to the Dr with my concerns and the problems Ive had since surgery and asked if he would still be willing to see me. I didnt hear anything so called and was put throught to his nurse. She confirmed the Dr received and read my letter and I asked if he would still see me and she said yes, they dont cancel appointments. My 2 oldest daughters took the day off work, I got all the records I could from surgeon and my family Dr and we drove 3 hours to my appointment. They did an x-ray ( I was scheduled for that before my dr appointment already ). An different ortho surgeon did the intake questions on everything etc. The surgeon came in, sat down and said, your appointment was for a second opinion on surgery. I mentioned my letter and he said he never saw or read it. He said I cant help you without a referral from your surgeon. We left. I was lost.. sad.. cant really describe the feeling. Let down.. I was SO HOPEFUL on getting some help.

            Comment


            • #7
              I'm sorry you had such high hopes and spent 3 hours driving back and forth and in the end got a sorry. That is ridiculous. I've never heard of that. If you really enjoy this surgeon and want to get his serious opinion, I think you should demand to be seen again and this isn't fair. If you can get a referral from your primary surgeon or even a general doctor, just get something to show them and say I waited a year and drove to and from this clinic, and in the end needed a "referral". That is horrible.

              Comment


              • #8
                That's very bizarre. If I were you, I'd probably write another letter (remain calm, and state only the facts). If I didn't get a response, I would probably protest the charges (with the exception of the X-rays).

                --Linda
                Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                ---------------------------------------------------------------------------------------------------------------------------------------------------
                Surgery 2/10/93 A/P fusion T4-L3
                Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                Comment


                • #9
                  I just want to say how sorry I am that you went thru all for nothing
                  Melissa

                  Fused from C2 - sacrum 7/2011

                  April 21, 2020- another broken rod surgery

                  Comment


                  • #10
                    Wow, how utterly disappointing and frustrating. I don't even know what to say other than I feel for you and do hope things work out much better for you next time. :-(
                    Son 14 y/o diagnosed January 20th. 2011 with 110* Curve
                    Halo Traction & 1st. surgery on March 22nd. 2011
                    Spinal Fusion on April 19th. 2011

                    Dr. Krajbich @ Shriners Childrens Hospital, Portland Oregon



                    http://tinyurl.com/Elias-Before
                    http://tinyurl.com/Elias-After

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                    • #11
                      I want help. I dont feel I can get that by complaining. I really need help.
                      I recently was able to get the charges reversed for that visit after being turned away, and with some outside help I was also able to get my insurance changed to one that covers this clinic.
                      As per the surgeons request for a referral from my surgeon in order to see me/ help me, I recently wrote a letter to my surgeon and I have had 2 calls from his office. The 1st sayingthat my surgeon said I have to be seen by him again ( In the past I had tried to make appointments and was told I could not see my Dr I would have to see his pain Mngmnt specialist again), and the 2nd saying that I have to have an x -ray now at his clinic before he will consider a referral for me.
                      I had an x-ray recently at the new clinic, so I surely dont need another one now from my surgeons office. (I also had 3 CT's in April so I dont believe more radiation is neccessary.)

                      Hopefully I can get his referral. It doesnt appear its going to be easy and or I may not get it.

                      Comment


                      • #12
                        Originally posted by leannebr View Post
                        I want help. I dont feel I can get that by complaining. I really need help.
                        I recently was able to get the charges reversed for that visit after being turned away, and with some outside help I was also able to get my insurance changed to one that covers this clinic.
                        As per the surgeons request for a referral from my surgeon in order to see me/ help me, I recently wrote a letter to my surgeon and I have had 2 calls from his office. The 1st sayingthat my surgeon said I have to be seen by him again ( In the past I had tried to make appointments and was told I could not see my Dr I would have to see his pain Mngmnt specialist again), and the 2nd saying that I have to have an x -ray now at his clinic before he will consider a referral for me.
                        I had an x-ray recently at the new clinic, so I surely dont need another one now from my surgeons office. (I also had 3 CT's in April so I dont believe more radiation is neccessary.)

                        Hopefully I can get his referral. It doesnt appear its going to be easy and or I may not get it.
                        Are you State side or in the UK?

                        Warmly,
                        Doreen
                        44 years old at time of surgery, Atlanta GA

                        Pre-Surgery Thorasic: 70 degrees, Pre-Surgery Lumbar: 68 degrees, lost 4 inches of height in 2011
                        Post-Surgery curves ~10 degrees, regained 4 inches of height

                        Posterior T3-sacrum & TLIF surgeries on Nov 28, 2011 with Dr. Lenke, St. Louis
                        2 rods, 33 screws, 2 cages, 2 connectors, living a new life I never dreamed of!

                        http://thebionicachronicles.blogspot.com/

                        Comment


                        • #13
                          In the states.

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