What is a Specialist and Why Do I Need a Referral?

General Practitioners are the first port of call when it comes to getting anything other than emergency room medical attention, but as the title suggests, general practitioners are generalists. Whilst GPs diagnose and treat a number of illnesses, injuries or conditions, sometimes the knowledge and skills of a specialist are required to give a patient the medical care they need.

Similarly, dentists and optometrists are also capable of treating a number of dental and ocular conditions but may require the services of someone with a more specialised skill set. Like GPs, dentists and optometrists can also refer patients  to specialists for more focussed treatment and care.

What is a Specialist?

Specialists are just that - medical professionals who specialise in one branch of medicine or in some cases, a specific condition or disease. Specialist doctors and other medical professionals, with few exceptions have all the training of a generalist of their field. A prosthodontist has full dental training, for example, as well as subsequent training in their field of expertise.

Being focussed on a narrow range of conditions, organs or diseases means that a specialist can deliver better or more focussed treatment than a general practitioner.

What are the Different Specialist Modalities?

There are many medical specialties, each with a different focus or area of expertise. Medical specialists to whom you may be referred include:

Cardiologist - cardiologists specialise in disorders or diseases of the cardiovascular system. They may perform procedures such as inserting pacemakers, angioplasty with stenting (unblocking of the coronary artery or arteries) or cardiac catheterisation (passing a thin tube through an artery in the neck arm or groin to the blood vessels of the heart). 

Dermatologist - dermatology is the study of skin and its related disorders. The skin is the largest organ in the body and can be subject to a huge number of disorders or diseases. It’s a dermatologist’s job to diagnose and treat these ailments. Commonly diagnosed and treated conditions include, psoriasis, dermatitis, eczema and skin cancers.

Endocrinologist - endocrinology is the study of hormones and the organs that produce them. Hormone imbalances can be a factor in a number of conditions, including cancers of the endocrine glands, diabetes, growth problems (lack of growth or excessive growth), infertility, menopause, osteoporosis and thyroid problems (hyperthyroidism and hypothyroidism).  

Book an appointment with a GP or search for specialists by location and availability is to do it online with MyHealth1st.

Endodontist - endodontists are dental specialists who study, diagnose and treat conditions of the dental pulp. Pulp is the soft, porous innermost part of the tooth that contains nerves, blood vessels and connective tissues, all of which are important for overall tooth health. Endodontists also diagnose and treat periradicular conditions (conditions in the tissue around the root of the tooth). One of the most common procedures performed by specialist Endodontists is the dreaded root canal, a procedure used to treat a tooth with infected pulp that would otherwise be extracted.

Gastroenterologist - gastroenterology is the study, diagnosis of conditions of and care for the gut (the gastrointestinal system). Conditions include oesophagitis, gastritis, inflammatory bowel diseases such as Crohn’s and ulcerative colitis , liver problems including hepatitis and cirrhosis, ulcers and stomach cancers.

Geriatrician - a doctor who specialises in caring for the elderly and diagnosing/treating the diseases that affect them, such as dementia, delirium, injuries from falls and Alzheimer’s disease.

Gynecologist - gynecologists are concerned with the diagnosis and treatment of women’s health issues. This includes diseases and conditions of the reproductive system, including breast and hormonal issues, pelvic and uterine disorders (including endometriosis ) and cervical cancer, as well as regular testing, such as pap smears. Many gynecologists are also obstetricians.

Haematologist - clinical haematologists specialise in the diagnosis and care of ailments related to the blood and blood producing organs, such as the spleen and bone marrow. Ailments include anaemia, clotting disorders, haemophilia, leukaemia, lymphoma, polycythaemia vera and thalassaemia. In addition to blood related diseases, haematologists are also experts in transfusion medicine.  

Immunologist and Allergist - Immunologists specialise in the diagnosis and treatment of immunological disorders, including immunodeficiency diseases and autoinflammatory syndromes. Immunologists are also involved with the research and development of vaccines. Allergists specialise in the diagnosis and treatment of allergic conditions, such as contact dermatitis, asthma and seasonal allergies (hay fever) .

Nephrologist - if your kidneys aren’t functioning properly, then you’ll most likely be referred to a nephrologist. These doctors specialise in the diagnosis and treatment of kidney diseases and conditions, such as polycystic kidney disease, nephrotic syndrome, high blood pressure and kidney failure.

Neurologist - neurologists are specialists in diseases, injuries and conditions of the central and peripheral nervous systems (the brain, cranial nerves, spinal cord, autonomic nervous system, peripheral nerves and the like). You may be referred to a neurologist for diagnosis and treatment for conditions such as multiple sclerosis , stroke, migraine , brain trauma, Tourette syndrome , Alzheimer’s disease.

Obstetrician - often specialised in alongside gynecology, obstetrics is a branch of medicine dedicated to the management and care of pregnancy, labour and birth.

Occupational Therapist - occupational therapists work helping people with injuries, illnesses or disabilities to help them better participate in everyday life. Occupational therapies include assessment, teaching self-care techniques, modification of environment to better facilitate activities, care coordination and case management. Occupational therapists are referred to as Allied Health practitioners rather than specialists.

Oncologist - an oncologist is a doctor specialising in the diagnosis and treatment of cancer. Oncology has three major areas of treatment. Medical oncology is the use of chemotherapy and immunotherapy to treat cancer. Surgical oncology is the removal of cancerous tissue through surgery. Radiological oncology is the treatment of cancer using radiation therapy. 

Ophthalmologist - a doctor that specialises in eye and vision care. An ophthalmologist can diagnose and treat diseases and injuries of the eye (including glaucoma , age-related macular degeneration and diabetic retinopathy ) prescribe medicine and perform surgery on the eye. In addition, an ophthalmologist can also perform eye exams and prescribe contact lenses or glasses.

Oral and Maxillofacial Surgeon - these surgeons specialise in the treatment of illnesses, injuries, diseases and abnormalities in the hard and soft tissues of the head, neck, face and jaw. Procedure performed range from the surgical extraction of wisdom teeth and the installation of dental implants, to adjusting and repairing misaligned jaws, repairing cleft palates and the removal of tumours or cysts in the mouth or jaw.

Orthodontist - orthodontists specialise in the diagnosis and treatment of misaligned teeth and jaws, overbites, occlusions and crowded teeth. Treatments usually involve specialist tools such as braces, aligners, dental plates and palate expanders (tools that widen the upper jaw).

Otolaryngologist - otolaryngology is the study of diseases, infections and conditions of the ears, nose and throat. Otolaryngologists are commonly known but the much easier to pronounce title, ENT (Ear, Nose and Throat). You may be referred to an ENT for an ear infection, hearing loss, balance issues, sinusitis, nasal polyps or an infection or disease of the larynx or oesophagus.  

Paediatrician - a paediatrician specialises in the health, growth and development of children from birth through to adolescence. You may be referred to a paediatrician when your child is sick, treatment for asthma or allergies, or assessment of growth or development. Unlike adults, children cannot make informed consent, so paediatricians work with both parents and children.

Periodontist - a periodontist is a dentist that specialises in the diagnosis and treatment of periodontal (gum) disease. A dentist can usually treat mild periodontal disease, so referral to a periodontist is usually limited to more serious cases. Treatments include root planing or debridement (cleaning of the tooth root or removal of infected tissue), gum surgery to remove or repair tissue and the placement, maintenance, and repair of dental implants.  

Proctologist - proctologists are surgical specialists in the treatment of diseases and injuries of the colon, rectum and anus. You may be referred to a proctologist for surgical treatment of conditions such as anal fissures, Crohn’s disease and ulcerative colitis , colorectal cancer, diverticulitis, gallstones, hernias, haemorrhoids and IBS (Irritable Bowel Syndrome). 

Prosthodontist - a prosthodontist a dentist specialising in reconstructive dentistry. This includes the replacement of teeth and associated tissue, dental implants, crowns, bridges, dentures treatment of temporomandibular disorders (problems with the hinge of the jaw), and more. Prosthodontists are also trained in the repair of dento-facial trauma (injury to the face and mouth).

Psychiatrist - psychiatrists are trained medical doctors concerned with the medical treatment of mental health issues. As doctors, they can prescribe medication and spend most of their time with patients managing medication instead of engaging in therapy (though psychotherapy is often involved in a psychiatric appointment). 

Psychologist - a psychologist is a mental health professional focussed entirely on psychotherapy, the treatment of mental health conditions through means such as behavioural modification (Cognitive Behavioural Therapy), mindfulness therapy, exposure therapy and family therapy. Psychologists are not medical doctors so cannot prescribe medication. Psychologists are Allied Health professionals rather than specialists but require referral for Medicare benefits.

Rheumatologist - rheumatologists are physicians specialising in the diagnosis and treatment of musculoskeletal problems and autoimmune diseases. Rheumatologists are expert in treating many forms of arthritis and other musculoskeletal conditions, including osteoarthritis, osteoporosis and fibromyalgia , as well as autoimmune diseases such as lupus , rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. 

Surgeons - a surgeon is a medical professional specialising in surgical treatment and repair of injury or illness. Some surgeons are classified as general surgeons as they have no specific area of expertise. Others may specialise in a specific field, such as cardiac, colorectal, orthopedic, paediatric, transplant, trauma or urology (kidney, bladder, urethra and adrenals). Unlike many other medical professionals, the official title of a surgeon is Mr.or Miss, not Dr.

*It should be noted that most specialisations also have sub-specialisations, such as a paediatric oncologist, a specialist in childhood cancers, or a surgical otolaryngologist, a surgeon who specialises in operations of the head and neck.   

Why Do You Need a Referral?

While it is possible to visit some specialists without a referral, having a referral brings with it a number of benefits. As your GP, dentist or optometrist will have made the initial diagnosis and has your medical history, they can provide all that information for the special to whom you have been referred.

Having a referral also conveys another important advantage. Most specialists bill privately, so a visit will entail an out of pocket expense. The exact price of the visit varies depending on the modality, the services provided and the individual clinic, as they can set their own prices. With a referral, patients are entitled to a Medicare rebate on out of pocket expenses, returning 85% of the MBS (Medicare Benefits Schedule) fee. 

For example, the MBS fee for an appointment with a paediatrician for early intervention for autism or developmental disability is $272.15. Medicare will refund $231.35 with a referral.

This rebate only covers the MBS (the part of the fee set by the government), so you may want to check with a specialist practice to see how they price appointments before making a booking.

How Long Does a Referral Last?

A referral is valid for a calendar year. That means all appointments with the specialist will be eligible for the Medicare rebate for that period of time. Once the calendar year is up you will need to return to your GP to get a new referral.

Do I Have to See the Specialist Named on the Referral Paperwork?

When writing a referral, a doctor will include the name and contact details of a specialist to visit. While this can make contacting said specialist and booking an appointment easy it doesn’t mean that there is a convenient availability in their schedule. Sometimes specialists can be booked out months in advance, leading to long waits for new patients.

The specialist referred to in the documentation is only a recommendation and you’re free to call other specialists (of the same modality of course) that are more conveniently located or have better availability.

The easiest way to book an appointment with a GP or  search for specialists by location and availability is to do it online with MyHealth1st. Our booking service is available 24/7, so you can easily search for and book the appointments you need, whenever you need to do it.

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