A concerning percentage of patients in the U.S. become victims of referral errors. Some primary care providers (PCPs) make mistakes when referring patients to specialists, which often results in harm to the patients.
Here is how a referral error can be considered medical negligence:
Misreferral
A misreferral occurs when a patient is referred to an unqualified or unlicensed provider, a wrong specialist, a provider who is too busy to schedule timely appointments or a provider with a record of disciplinary action or professional censure.
Examples include when a PCP:
- Misdiagnoses a cardiac issue as acid reflux, referring a patient to a gastroenterologist instead of a cardiologist
- Refers a patient to a specialist who, despite possessing specific clinical expertise, can’t see the patient for a long time, even though the patient requires immediate medical evaluation
- Fails to perform adequate evaluation on a physician, resulting in them referring a patient to an unqualified specialist
A PCP should take reasonable steps to make an appropriate referral.
Incomplete information
Some specialists have to constantly contact the PCP to obtain recent blood work, prior imaging, medication lists, charts, patient history and other missing crucial details. A specialist can even reject a referral because of insufficient information. A PCP failing to effectively communicate with a specialist can delay treatment.
Failure to refer
A PCP may fail to refer a patient to a specialist after recognizing the patient’s condition goes beyond their expertise. This can happen because of diagnostic errors, overconfidence and financial benefits.
Abandonment
A PCP may be considered to have abandoned a patient if they end the doctor-patient relationship without ensuring a proper transition to a specialist.
A referral error can lead to the worsening of a patient’s condition. If you or your loved one has been harmed due to such an error, consider seeking legal guidance to know your next steps.