A referral for an examination or to a specialist doctor sooner or later is necessary for all of us. Has it happened that the doctor at the clinic refused to give you a referral for medical examinations? Probably yes … Usually it is not a sign of ill will, but a necessity to obey the rules. Read what kind of referral for medical examinations can be issued by your GP.

It is not easy to geta referral for an examination under the National He alth Fund . The type of medical care we can count on when using the services of a doctor under the National He alth Fund is stated in the Act on General He alth Insurance and the regulations issued to it. These documents strictly define not only the competences of doctors, but also the scope of tests that they can order their patients. These regulations apply to both the primary he alth care physician (POZ), general practitioner or family doctor, as well as specialist doctors working under contracts signed with the National He alth Fund.

Your primary care physician orders some diagnostic tests

A primary care physician has the right to issue a referral for certain free examinations, if it is required by the diagnosis, i.e. when the patient presents a he alth problem. This list includes laboratory blood tests, urine tests, and stool tests (including screening tests, for example from a throat swab). From X-ray examinations, these are x-rays of the skeleton (including the skull and sinuses), the chest and the abdominal cavity. However, they cannot be pictures taken with the use of contrast, e.g. x-ray of the gastrointestinal tract with contrast. We will also receive a referral for an ultrasound scan from a GP, but only if it concerns the abdominal cavity. However, we will not get orders for ultrasound of the thyroid gland, salivary glands or lymph nodes. Note: from January 2010, the primary care physician cannot refer patients to the so-called cost-intensive tests, i.e. computed tomography, magnetic resonance imaging, Doppler blood flow assessment. He was responsible for endoscopic examinations of the upper and lower gastrointestinal tract, such as colonoscopy and gastroscopy.

Prophylactic examinations only for people at high risk

A lot of people would like to do some basic blood and urine tests just to be sureabout your he alth. "I haven't done any tests in a long time," they explain to the doctor. Unfortunately, the financial collapse of the state he alth service does not allow for free preventive examinations. With very limited resources, the doctor must follow medical indications. If the patient does not report specific ailments, there are no symptoms that indicate a developing disease, there is no reason to order even the simplest analyzes. Chest X-ray, abdominal ultrasound or blood and urine analyzes are an expense that significantly exceeds the rate provided by the National He alth Fund for the annual treatment of one patient. The physician must rationally spend the funds at his disposal. If, after a detailed interview and examination of the patient, he finds no grounds for the examination, he will not issue a referral.

Important

Doctors you can go to without a referral

Without a referral from your primary care physician, you can go to:

  • psychiatrists,
  • gynecologist,
  • oncologist.

We do not need a referral also if we want to heal from addictions or seek help in a mental he alth clinic.

The situation changes if the patient is at a higher risk, e.g. obese, smoking or having cancer in his family - it will be necessary to carry out analyzes or refer to a specific specialist to confirm or rule out the disease. Routinely, e.g. after the age of 50, a doctor should refer you for a fecal occult blood test. It is much cheaper than a colonoscopy and its sensitivity exceeds 90%.

Referral to a specialist and treatment by a specialist

If the family doctor decides that the patient should be examined by a specialist after basic examinations, he or she must issue an appropriate referral. Specialist treatment, with few exceptions (see box), requires the recommendation of a primary care physician. But when the patient is under the care of a specialist, he will continue the treatment. If he decides that a consultation of e.g. a diabetologist or a gastroenterologist is needed, he is obliged to issue an appropriate referral, and not to send the patient to the family doctor. The primary care physician has no right to write out such a referral, because he does not have the appropriate medical documentation.

It is similar in the case of referrals for surgery, rehabilitation or treatment in a sanatorium - only a specialist may issue them on the basis of the tests ordered by him.

There is no limit of research to monitor treatment progress

The patient does not have to worry that in the event of a serious or chronic disease, the doctor will limit the number of tests that allow to monitor his he alth. The frequency of ordered analyzes always depends on the type of disease. For example: with anticoagulant treatment, blood analysis is performed every 1-2 weeks, in the case of atherosclerosis - once every few months.

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