Posted by Dayna on 3/12/99
stands for Health Maintenance Organization. The most common set-up is that you have to pick a primary care physician, when you are ill you go to them and they will decide whether or not you need to see a specialist. I cannot recommend them as a general rule, since the primary care physician is graded partly on how many referrals they do, more referrals mean a bad grade and maybe being kicked out of the HMO. They also have a per-patient amount of money to spend, so if I need something expensive and use up all my share, they have to hope someone else doesn't use all of theirs. My experience is that if you have an informed patient, they know when they need a specialist for something, such as PF. All the referral does is make you see a doctor who tells you it's ok to go to the specialist that you already knew you needed to see. In my case the answer was "No, there's nothing anyone can do, you'll just have to learn to live with chronic pain". I ended up paying myself to see my podiatrist but my excess pain was relieved within two days, and my insurance paid the PCP $169 for less than five minutes of his time. They would have saved over $100 if they'd just let me go to the podiatrist right off.

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