I don't actually believe that health care plans do insist on patients seeing a specialist. I might be wrong, but that doesn't make any sense financially speaking. Most insurance companies are out there to make a profit. Everytime a patient has to go to another doctor especially a specialist, it's going to cost them more money, thus cutting down on their bottom line.
With all due respect to doctors, and I don't feel guilty about saying this even though I am dating one, as he doesn't send his patients out to specialists unless the patients problem is beyond his scope of practice, or his skill set, which does happen, but not very often, doctors sending patients out to specialists is a way of self protection for them.
The fact is, most family doctors or general practitioners are very capable of treating and diagnosing 90 percent of what ails their patients, if they are worth the paper their diploma is written on anyway. Women think they need to see the gyn for their pap smears and breast exams, but really, a GP, even a little Doc in a Box is able to do that. Hell, in a lot of countries Nurses do paps and breast exams. Only when things are truely over a GP's head does he/she need to send a patient out to a specialist.
And personally speaking, I am a one stop shopper. My time is limited, and precious. I don't have time to be going to doctor after doctor. In order for my GP to be able to treat me effectively, he needs to give me a complete physical, he needs to be the one who knows what's going on and with what. When too many hands stir the pot so to speak, ingredients get missed due to lack of communication. Same can be said in health care.
I would think that if a patient would talk to their doctor and tell them that they don't want to go see a specialist unless they had a problem that the GP couldn't handle, such as the case with my kidney stones, I mean oboviously Doc wasn't able to take me to surgery and laser them out, then most GP's would be more than happy to not send out their patients. Doing so just takes money out of their pockets as well. You have to remember, a good doctor wants to get you better, fix you. The more he sends you out for the less he knows about you which hinders his ability to correctly take care of you in the first place. And the less he knows, the more he opens himself up to miss something, prescirbe something that contradicts maybe another medication the specialist already has the patient on, something of this nature. And with GP's malpractice insurance costing them in upwards of 100 grand a year, trust me, he doesn't want to make a mistake.
It all boils down to better communication, between the patient and the doctor(s), and between the doctors offices in which the patients go to. I know a case in which the patient was self medicating with an over the counter medication, a medication from the health food store actually. She didn't disclose that she was taking that medication. Her specialist prescribed a real medication and the two interacted horribly. It caused the patient to go into kidney failure. She sued her doctor, thankfully she lost. She didn't disclose all of her medications, whether it was prescriptions or over the counters. She didn't have good communication, she didn't properly educate herself, and now she will pay the ultimate price....her life.
Mashie