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What is a referral?

OSHCstudents – A referral is a written request from one health professional to another health professional or health service, asking them to diagnose or treat you for a particular condition.

What does a referral do?
A referral provides information about you and your condition so that:

  • the person you are being referred to does not have to ask so many questions
  • they are aware of relevant background information
  • they know exactly what they are being asked to do
  • A referral is also used to indicate that the consultation or test you are being referred for is clinically important, and that Medicare should cover at least part of the cost.

When might I need a referral?
Your health professional might refer you to someone else if:

  • they believe you need expertise that the other person has
  • they believe you need treatment that the other person can give
  • they believe you need specialised tests or investigations

For example, someone with pregnancy complications may be referred to an obstetrician, or a person with cancer may be referred to an oncologist and surgeon.

You are likely to need a medical referral or request to:

  • see a specialist
  • get x-rays or use other diagnostic imaging services
  • use pathology services, such as blood tests

What information does a referral include?
The referral should include:

  • relevant clinical information
  • the date of the referral
  • the signature of the referring practitioner

You can choose the individual specialist you want to be referred to or ask your doctor to recommend someone. The doctor can address it to a particular person or make a general referral without using the name of the specialist (for example, addressing it to ‘Dear psychiatrist’.)

How long does a referral last?
Most referrals from general practitioners (GPs) to specialists are limited to 12 months. They should cover a single course of treatment for the condition you are being referred for. The referral covers all the visits to the specialist for that condition.

If you need continuing care, such as for a chronic (continuing) health condition, the GP can write a referral beyond 12 months or for an indefinite period. If you develop a new condition, you will need a new referral for that condition.

Referrals from specialists and consultant physicians to other specialists are limited to 3 months unless the patient is admitted to hospital.

Who can make a referral?
Referrals can be made by doctors, dentists and certain allied health professionals — nurse practitioners, midwives, physiotherapists, osteopaths, optometrists and psychologists.

Some services can only be ordered by a particular specialist. For example, you may need a referral by a specialist for certain types of MRI scans.

How do I get a referral?
Make an appointment with your GP or doctor and ask them to write you a referral. You can discuss your needs with them, and they can properly assess you.

This helps to ensure that the referral contains the information the other health practitioner needs.

Getting a second or further opinion
If you are unhappy with a diagnosis or feel there might be better treatment options, do not be afraid to ask your doctor to refer you to another specialist for a second opinion.

What happens if you visit a specialist without a referral?
Many specialists will still see you, although some might not. But Medicare will not cover any costs if you visit a specialist without a referral.

Sharing information and privacy
The referring doctor or health professional will provide the specialist with as much information about your condition as they think is needed. Once the specialist has seen you, they will in turn send details of your recommended treatment back to the doctor or health professional who referred you. All your medical information is regarded as private and confidential.

If you are uncomfortable with this, talk to your referring doctor or health professional.

OSHCstudents (source: healthdirect)

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