Americans are now booking appointments with more medical specialists than ever before. In fact, patients see specialists for more than half of all doctor visits each year. Here’s how it happens: Perhaps your primary care doctor refers you to a cardiologist for a heart problem, and the cardiologist then refers you to a thoracic surgeon for a bypass procedure. In most cases, such referrals are on the up-and-up. They get us to high-quality practitioners who have more experience with the health problems we may be having and/or regularly perform the medical procedures and services we need. But are we always being referred to the best physicians available? Not necessarily. 

That’s because today’s physicians often have conflicts of interests that push them to refer you to a doctor or facility (such as a radiology center) with whom they have a financial interest. To protect ourselves, we—as patients—must be watchful and take steps to ensure that we are being sent to the best person or facility for our health problems. Here’s how to do that…

• Ask the right questions. Doctors in large medical groups or employed by hospital/medical centers are often pressured to refer patients to doctors or facilities within the same organization. Legally and ethically, however, doctors are supposed to inform you if they are referring you to a practitioner with whom they have a financial connection. This includes doctors or clinicians in their same medical group or employed by the same hospital medical center—both of which could mean that your fees stay within the same organization or the referring physician could be getting a bonus. Such connections don’t necessarily mean the referral is not a high-quality physician, but doctors frequently fail to alert patients to these conflicts of interest, according to research. To protect yourself or a loved one, you must ask certain questions

My advice: Whenever you’re referred to another doctor, always ask why that particular one is being recommended—especially if the recommended doctor is in the same practice. You can say something like: “I don’t mean to offend you but simply want to understand why you are referring me to this particular doctor.” Most doctors giving a solid referral will gladly give you some convincing reasons why the physician is being recommended.

• Don’t just take your doctor’s word. It is always smart to do your own research to check out specialists beyond those being recommended by your doctor. 

My advice: Contact major medical centers in your area that are not affiliated with your referring physician and ask for a list of their specialists. Also, don’t hesitate to contact nationally known medical entities such as the Mayo Clinic ( or Cleveland Clinic ( that may have specialists who practice at one of their locations closer to you.

• Remember to put your needs first. Your physician’s first interest should always be serving your medical needs. And the more you know about his/her business relationships with other entities, the better your chances of making the right medical decisions for yourself. 

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