I'm just being devils advocate here (I know less than nothing about the medical system).
a) What if they have no choice? Specialization becomes mandatory.
b) Valid point. The only counter I have to that is nurse practitioners. Not the strongest argument, I admit.
c) That's what the specialist's secretary is for. You call and tell her the problem, she either pencils you in or tells you to gtfo.
d) Back to the secretary. Contrary to what a lot of people may think, they actually have some medical knowledge. You have a problem with your kidneys, here's the list of nephrologists close by.
e) Google has that same information.
On the other hand, I'm sure there's a spreadsheet somewhere with the most common specialist visitation statistics. Let's say, 25% of referrals were for skin problems, 20% for back pain/injury, 20% for joints, 15% for digestive problems, and the remaining 20% for everything else, then why not eliminate the need for referrals for the top 4 or 5 specialities to speed things along? Knock out 20 of the GP's in my town, and put it 4 or 5 of the most frequented specialists. When you go to a GP, that's one appointment, just so that you can make a second appointment somewhere else. Remove the first appointment, and by design you've freed up time for someone else. Furthermore, why not have more nurse practitioners doing work that they're already capable of, but aren't allowed to do. A nurse could stitch you up in triage, why are they limited to taking blood pressure and asking where it hurts? Hell, a seamstress could stitch you up given the proper....thread. Maybe even do a nicer job
All point seem valid but not in the real world. If Triage starts stitching in the waiting room then the flood of patients at the door will wait longer to just SEE the triage. Someone having a heart attack has to wait for the patient to get stitched???. On top of that the liability of the patient having infection from the laceration. It gets more complicated.
And re: patients going straight to a specialist. I.e. most neurologist wait times for a referral are months to years. That is with the GPs filtering those patients telling them its nothing a neurologist should see. Now take away the GPs and have them go straight to neurologist. I would assume the wait times would be couple of years+. And seeing a specialist can sometimes mean multiple visit. They will need to order blood work and imaging ant etc. The GPs can get those orders done before even having to be referred to the specialist. No system is perfect.
