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Six-month re-referral requirement for specialists to be scrapped

Patients won’t need to ask their family doctor for a new referral after six months to see a specialist for the same condition, starting July 1
Joshua Greggain, president of Doctors of B.C. COURTESY JOSHUA GREGGAIN

Patients will no longer be required to ask their family doctor for a new referral after six months to see a specialist for the same condition, starting July 1.

Doctors of B.C. president Joshua Greggain, who is based in Victoria, wrote to physician members this week to say the association has been working to streamline the re-referral process, which he called burdensome to referring practitioners, consultants and patients.

The changes are part of a $708-million three-year Physicians Master Agreement negotiated between the Health Ministry and the Doctors of B.C., inked in October and ratified the following month.

The requirement for re-referrals forced patients with a family physician to book appointments just to request a referral to see their specialist again. Specialists’ offices were unable to book subsequent visits after six months until they received the required re-referral paperwork from the family doctor or other practitioner.

The result was more work for increasingly busy doctors.

“It’s one of the burdens from an administration of practice that has beleaguered both family physicians and specialists,” said Greggain. “This was one thing we could change and find some common interests.”

When specialists see a patient by referral, they can bill for a “consult,” which pays more than subsequent “visit” fees, while family doctors can bill to write referrals.

With the new referral fee structure, specialists seeing a referred patient after six months can bill a full consultation if all requirements of a consultation are met, while family physicians will no longer charge MSP for unnecessary re-referrals.

“This has more to do with flow and follow-up than it did any resources,” said Greggain.

The so-called implicit re-referral will allow the patient and consultant to schedule a subsequent visit at intervals of greater than six months if the issue is the same medical condition, unless the referring practitioner specifically disallows it.

Consultants, meanwhile, can discharge patients from their care any time they feel it is appropriate, according to the Doctors of B.C. website.

Also, a referral to a specialist remains valid even if the referring family physician has retired, according to the association’s website.

Referrals can also be made by nurse practitioners, registered nurses, chiropractors, dental surgeons, optometrists, midwives, and podiatrists.

A working group has been established through the new Physician Master Agreement to alleviate further administrative burdens, such as forms required for some task, said Greggain.

Doctors of B.C. is offering physicians webinars June 20, 22, and 28 to support them through the re-referral changes.

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