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Why you need to ask tough questions about referrals to medical specialists

Referrals are the lifeblood of business. There's nothing like a strong recommendation to bring in customers, clients and -- increasingly -- medical patients.

Specialists grappling with smaller insurance reimbursements and increasing costs are turning to marketing professionals to expand their businesses. The marketers seek out primary care doctors who might be a good match with the specialist they represent. Then they go door-to-door, trumpeting their client’s merits in hopes of winning referrals.

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Ask your doctor about the specialistPatients are accustomed to seeing pharmaceutical salespeople in doctors’ offices, and some aren't thrilled with the practice. They question whether the doctors are prescribing the best medicine or simply responding to the marketing. However, many patients haven't thought twice about how their doctor selects a specialist.  

There is an assumption that primary care doctors will send you to the best of the best, a specialist who is established, highly qualified in his or her field and, most importantly, well-known by your doctor. Well, you know what they say about assuming.

ConsumerReports.org offers advice to patients about how to choose a specialist.

The business of medical marketing

There's a lot to worry about when it comes to the business of medical marketing. For one thing, are marketers willing to promote anyone who can afford their fee, regardless of ability? According to a recent article in Smart Money magazine, consulting marketers charge $3,000 to $10,000 per month.

"While this public relations ploy may be good for doctors wanting to expand their patient base, it is troubling for patients. Patients assume when a doctor makes a referral that it is based on his or her own personal knowledge of that specialist, and not because the doctor has been subjected to a sales pitch touting the other doctor," says Edgar Dworsky, creator of ConsumerWorld.org, an online consumer guide. "In a sense, this is essentially the same as the doctor being influenced to prescribe a particular drug after having been visited by a salesperson from a pharmaceutical company."

Is there an inherent conflict of interest? "One would hope that the doctor evaluates information he or she may have heard or read about a particular specialist, as well as from personal experiences, to come up with the most appropriate choice for the patient," says Dworsky.

According to Smart Money, even for simple referrals, critics complain that patients -- who get nearly 70 percent of specialist referrals from their primary care doctors -- have no idea that this world of white-coat wooing exists. The American Medical Association's Code of Medical Ethics requires doctors to provide patients with "relevant information" about potential procedures, but has no guidelines on what to tell them about the specialist to whom they're being sent, reports Smart Money.

It’s not all bad

Medical marketing isn't all bad. On the plus side, primary care doctors may be introduced to specialists they might not come across in their everyday practice.

So what's all this mean for you? You've heard it before: advocate for yourself. Don't be shy about asking your primary care doctor questions. For example, says Dworsky, "Why are you referring me to this particular doctor? Do you have personal experience with this doctor that would suggest that he or she is the right one for me to see?"

You might get a surprised look, but that's OK. You have every right to ask.

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