The question: My child needs to see a specialist. How does my family doctor choose which one we'll be referred to, and can I suggest someone?
The answer: In my experience, family physicians refer to specialists that they have worked with in the past – specialists that they know can provide the specific diagnostic and treatment services that your child needs. There are a number of factors that a family physician may consider when making decisions about referrals. Ideally, the family physician knows that the specialist is competent and capable of managing the problem. Wait times are another factor; if there are two or more specialists that can address the problem, the family physician may recommend the specialist with the shortest wait time. The family physician may suggest the specialist that they believe has the personality or bedside manner that will be the best fit. For example, some teenagers may feel more comfortable with a specialist who is the same gender.
I may be a bit biased, but when the health of children is involved, the best initial referral is to a pediatrician. Community pediatricians are generally widely available in all but the smallest of communities. Pediatricians have the training and experience to assess most childhood medical complaints and are often the only specialist that your child will need. A pediatrician will also be very familiar with the treatments offered at the nearest children's hospital, and can facilitate your child's referral to these specialized services if required.
You can certainly suggest a certain specialist. Often families have heard of someone through word of mouth. If your family physician believes that another specialist is preferable, they will discuss this with you. As long as the specialist that you suggest is a reasonable choice, there should be no problem getting the referral.
Send pediatrician Michael Dickinson your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.
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