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Examples of self-referral include an internist performing an EKG, a surgeon suggesting an operation that he himself would perform, and a physician ordering imaging tests that would be done at a facility he owns or leases. [1] The ability to self-refer is an incentive for physicians to order more tests than they otherwise might.
If their reviews were negative, the practicing physician could face a lawsuit from a maltreated patient. [22] Such practices are known to have continued into the 11th century. [23] In the 1900s, peer review methods evolved in relation to the pioneering work of Codman's End Result System [24] and Ponton's concept of Medical Audit. [25]
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In medicine, referral is the transfer of care for a patient from one clinician or clinic to another by request. [ 1 ] [ 2 ] Tertiary care is usually done by referral from primary or secondary medical care personnel.
PCPs are usually internists, pediatricians, family doctors, geriatricians, or general practitioners (GPs). Except in medical emergency situations, patients need a referral from the PCP in order to see a specialist or other doctor, and the gatekeeper cannot authorize that referral unless the HMO guidelines deem it necessary.
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Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician (or an immediate family member) has a financial relationship with that entity.