How to request/get a referral to another doctor?

July 19, 2009 6:26 PM

How does getting a medical referral/requesting a medical referral REALLY work and how do you ask for one effectively?

My mom recently got a preliminary cancer diagnosis (from a CT scan for an unrelated injury) at a medical center in Maine where she's staying for the summer. She was told that a likely first step is to remove the kidney with the mass, sooner rather than later. She's only been seen by her GP at this point.

My family wants her to be seen in Boston at a comprehensive cancer center like Dana Farber right away, before the ball really gets going in Maine. Oh, and she's a senior with MediCare.

She has a urology appt tomorrow morning as her first follow-up since the "we found a mass" news, and I want her to get a referral to Dana Farber, but I realize I'm not 100% sure how this works.

Can she simply say to the urologist, "please refer me to DF" without having a name of a specific doc? If she does, will the doc just go ahead and call DF and find someone to see my mom?

Or does the doc just say "OK" and call DF to tell them we're going to call them to make all arrangements??

Thanks for any help, we're all completely clueless about this process and I want her to have a good "script" when she goes in tomorrow.

posted by tristeza to health & fitness (4 comments total)

I used to work at Dana-Farber, albeit on the pediatric side. But the long and short of it is:

1. You can call yourself, or use their online form. Plenty of info there.
2. Just ask your doctor to refer you (and make sure that he/she sends notes, scans, pathology reports). If Maine isn't your mother's primary place of residence and she wants to be treated elsewhere, that's her prerogative. Her GP isn't going to treat her, so he/she should be fine with her geographical preference. Plus, if you mom wants to be treated at a comprehensive cancer center, then her physician(s) should respect that. All you have to do is say, "Our family discussed this and we'd like to be referred for evaluation at Dana-Farber. Can you help us facilitate that?".
3. The docs in GU oncology at DFCI are great. Phil Kantoff has a national reputation as does Bill Hahn (as both a physician and scientist).

Best of luck.
posted by scblackman at 6:38 PM on July 19 [2 favorites has favorites]

I used to work as an office manager in a family practice and our referrals worked like this: You tell your GP (or your GP tells you) who you would like to or ought to see for specialist care. Your GP fills out a form of some sort saying "Please see patient X for condition Y; here are pertinent details and please get back to me with anything you find." This form gets either faxed to the relevant clinic or is hand-delivered by the patient at his or her first appointment.

The big reason for referrals is to prevent unnecessary specialist care (do you really need an otolaryngologist for your sniffles?). Your insurance company just wants to know your primary care provider thinks the specialist is necessary and relevant.

It should be a relatively quick and painless process, unless there is some reason your GP does not think the referral is suitable.
posted by girlstyle at 8:39 PM on July 19

Do make sure you get any relevant imagery, lab results, etc... sent over first, as this will save both you and the specialist time and effort. Good luck with your mom's treatment!
posted by zachlipton at 8:45 PM on July 19

When my daughter was diagnosed with brain, spine and kidney cancer, the docs here at Childrens Hospital of Philadelphia (CHOP - the #1 pediatric oncology hospital in the country, IIRC) did not want us to go to St. Jude, and initially frustrated our attempts to get a referral there. They said we would not qualify for any existing St. Jude trial, and thus did not have access to that hospital. Turns out they were wrong, and I did the legwork myself and got there.

So, absolutely ask the docs to make the specific referral, but if you hear from them that you can't, shouldn't, won't be accepted or anything else, do NOT let it go at that. Contact the hospital directly, and be very concise and specific in the email. I was able to give dates of tests, size and specific location of the masses, complicating factors, the proposed but unconfirmed by pathology diagnosis, etc. And it is critically important that you obtain and are able to provide all imaging, as others have said. For me, I did not go through the online referral, I emailed the coordinators (not the doctors themselves) directly. I sent my first email on August 7, 2008, and by August 17 we were in Memphis for surgery on August 19. So much for "St. Jude won't accept her"!
posted by bunnycup at 6:41 AM on July 20 [1 favorite has favorites]