Referrals From Your Primary Care Physician (If Necessary: Fill & Download for Free

First and foremost, if this problem is acute and emergent, the most obvious answer is the Emergency Department. If this is not the case, a great first step for most health problems (chronic or acute-but-non-emergent) would be to see your primary care physician. If you do not have a primary care physician, this shoulder problem could be your chance to find one and establish a relationship with that doctor. Depending on your insurance, you may need a referral from a primary care physician to see any specialist (this is in the US), so having a primary care physician is useful in more ways than one. Your PCP may then refer you for X-Rays or an orthopedic evaluation if necessary.

I lived in Canada prior to 1986 and in the USA since then.The medical care I received in both countries was similar. The differences that affected me were how care was payed for.In Canada (mostly Ontario) I had an Ontario Health Insurance Plan (OHIP) card and simply provided that card or number. I could contact any primary care physician I wanted to, do not recall long waits for appointments, and obtained referrals to specialists when that was necessary. I do not recall long waits for appointments with specialists though I rarely needed them.In the USA I only have coverage while I am employed. I have had three periods of unemployment during which obtaining medical care was problematic. For the longest period of unemployment I used the COBRA plan to continue medical coverage, but this was extremely expensive. During subsequent (and shorter) periods of unemployment I obtained high deductible basic coverage, though again at high cost.In the USA I am limited in the primary care physicians I can see, based on what the insurance provider my employer selected, chooses to cover. Similarly, when I need a referral to a specialist, the choice of specialists is limited by which specialists of that type are on the same insurance provider “network”.I have also had the US insurance provider deny to pay the Doctor’s bill. I needed surgery, went to the surgeon I was referred to by my primary care physician, had the surgery, but was told by the insurance company after the fact that the surgeon’s fee exceeded what the insurance company considered “usual and customary” and I was responsible for the $1000 difference. More recently my girlfriend had some very serious medical issues requiring two surgeries, and despite being covered by what was termed by her employer a “Cadillac” plan, she was out of pocket for $10,000 in hospital and Dr. fees that the insurance company did not cover.In my experience, waits for primary care and specialist appointments were similar in Ontario and in the USA.While hard to judge effectively from my relatively limited use of medical services, I believe I have had similar quality of care in both countries.The insurance system is what makes the big difference between the two. In every medical office in the USA, someone has the job of filing perfect insurance claims. That claim is filed with the insurance company where a specialist searches for reasons to deny the claim. Neither role provides any value to the patient seeking health care, or the Doctor provider.Actually, the US system does exactly what it was designed to do, which is allow insurance companies to make a profit. Because most of the insured in the US are covered by insurance plans provided by their employer, the employer chose the plan, not the consumer of the medical services. So the system does not effectively allow consumers to choose their insurance provider, and it restricts their choice of medical provider. So much for the benefits of capitalism!In my experience, the Ontario system (and the other provinces plans are roughly similar though they differ in detail) provides the same level of medical care (though I never needed the most advanced medical care), with no restrictions on which Doctor I went to, and gave me that care with no out of pocket charges to me.It also provides coverage to all residents, which is a key point for me.

Contact an ophthalmologist immediately. If necessary, get a referral from your primary care physician. Time is of the essence with a retinal detachment. Delay can cause total loss of vision.