I know there are medical professionals on the DU. I have an issue with gatekeeper medical care.

[MineralMan]

4. I'm not a medical professional, but this is driven primarily by

health insurance company policy. Since specialists bill at higher rates than primary care doctors, they want people to go to the primary care MD first. That's because, in most cases, the primary care doc can treat immediately and the specialist might not be needed. If needed, the referral gets made. Of course appointments with specialists are often hard to come by in a timely way.

Different insurance companies have different policies, though. And it takes different amounts of time to be seen, even by primary care doctors, depending on where you live. In the Twin Cities and with my insurance's health care system providers, I can be seen the same day or the next day by a primary care doctor - usually my regular one. My network includes one of the largest clinical networks in the area. Specialist appointments within that system can take a couple of weeks to a couple of months. That depends partly on how serious the issue is, of course.

There's no one answer to your question. It depends on many factors. However, in most systems, you're going to have to be seen first by a primary care doctor before you get referred to a specialist. In truth, most specialists won't make appointments for self-referred patients. They also want an evaluation by a primary care physician as part of their triage protocols. Otherwise, they see too many patients who don't need their services and who could be treated at the primary care level.