A Doctor for Every Disease
This chapter comments on some of the problems associated with “poly-doctoring,” the excessive and expensive referral to multiple specialists. It discusses four scenarios that indicate the rationale for specialty referrals. In the first scenario, the primary care physician knows exactly what is wrong with the patient and what is required of the specialist to deal with the problem. In the second scenario, the physician has no idea what is wrong with the patient, and so the chapter consults a specialist for help with the diagnosis of a perplexing problem. In the third scenario, the patient and his family make their own “referral” to a specialist, without the recommendation, consent, or possibly even the prior knowledge of the physician. In the fourth scenario, the physician knows exactly what is wrong with his patient and what is required in the way of treatment. The chapter also discusses the various outcomes of specialty consultations and concludes by considering ways of improving doctor-to-doctor communication and getting more useful results for poly-doctored patients.
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