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Navigating the health care system is daunting, especially when determining which type of doctors or medical specialists to see for specific health concerns. Understanding the role of your primary care physician and various medical specialists will help you make informed decisions about your health care needs.
Learn about the different types of medical specialists and when you may need a referral to visit a specialty doctor.
Primary Care Doctors
Primary care doctors are the entry point to the medical system. They provide a comprehensive approach to care, including prevention, treatment and rehabilitation of health issues. Primary care doctors also help coordinate care when you need to see a specialist.
Having a primary care doctor allows for an ongoing patient-doctor relationship built on mutual trust.
There are different types of primary care doctors:
— Internal medicine doctors. Also called an internist, internal medicine doctors manage common and complex illnesses typically for adults and older adults.
— Family medicine doctors. Family medicine doctors provide continuous care for people of all ages, backgrounds and conditions, often caring for entire families from birth through the end of life.
— Pediatricians. Pediatricians are a type of primary care doctor specializing in the care of infants, children and adolescents. They provide primary and preventive care, including administering routine immunizations or providing acute care for common childhood illnesses, like ear infections, colds and flu and minor injuries.
Starting with a visit to your primary care physician is a great way to assess whether or not you need to see a specialist.
“Sometimes, I’ll say to the patient, ‘I can take care of that. You don’t need to go to the specialist at this point in time,'” says Dr. Theodore Strange, chair of medicine at Staten Island University Hospital, a division of Northwell Health, in New York City.
In fact, upwards of 95% of cases can be taken care of with good primary care, says Dr. David Cutler, a board-certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, California. “The referral itself is the exception,” he adds.
[READ: Health Questions to Ask Your Doctor]
When to See a Medical Specialist
However, there are a few reasons doctors may refer patients to a specialist, including:
— If the patient has a certain chronic or complex disease with symptoms that may need specialist testing. For example, someone with a cardiac condition may need a stress test, or an individual with a GI condition may need a specific type of endoscopy or colonoscopy.
— If you have the results of testing and need a more expert interpretation of the test to better treat the case.
— If there’s a patient with an uncertain diagnosis. A primary care physician may refer you to a specialist if they have run out of options and need an expert with more specialized medical knowledge to diagnose and treat you.
— If you need or want a second opinion.
[READ MD vs. DO: What’s the Difference?]
Types of Medical Specialists You Might Need
Medical specialists have additional training and expertise in a specific area of medicine. Some even subspecialize, meaning they have even more specialized training within their specific field of medicine.
Below are several common medical specialists you might see.
Allergists-immunologist
— What is an allergist-immunologist? An allergist-immunologist diagnoses, treats and manages disorders related to the immune system, immune deficiency diseases and adverse reactions to triggers, such as drugs or food.
— What do allergists-immunologists treat? Allergist-immunologists treat allergic rhinitis (hay fever), food allergies, asthma, eczema, immunodeficiency disorders and other conditions related to the immune system.
Cardiologist
— What is a cardiologist? Cardiologists deal with the prevention and treatment of disorders of the heart and vascular system.
— What do cardiologists treat? Cardiologists treat cardiac issues, such as coronary artery disease, heart failure, arrhythmias and congenital heart defects.
Dermatologist
— What is a dermatologist? Dermatologists are medical specialists trained in the diagnosis and management of conditions related to the skin, hair and nails.
— What do dermatologists treat? Dermatologists treat a wide range of issues, including acne, rashes, eczema, psoriasis, skin infections and skin cancer. They may also treat patients with cosmetic concerns, such as wrinkles or acne scarring.
Endocrinologist
— What is an endocrinologist? Endocrinologists are doctors who focus on disorders related to the endocrine system, which involves the glands and organs that make hormones.
— What do endocrinologists treat? Endocrinologists treat patients with endocrine conditions and disorders, such as diabetes, thyroid disorders, metabolic abnormalities and hormonal imbalances.
Gastroenterologist
— What is a gastroenterologist? Gastroenterologists, or GI doctors, manage diseases of the gastrointestinal tract, including your esophagus, stomach, bowels, liver, pancreas and gallbladder.
— What do gastroenterologists treat? Gastroenterologists treat GI conditions, like cancer, hepatitis, irritable bowel syndrome, diarrhea or constipation, heartburn and ulcers.
Geriatric medicine specialist
— What is a geriatric medicine specialist? Also referred to as geriatricians, specialty doctors of geriatric medicine have specialized knowledge related to aging and training in diagnostic, therapeutic, preventive and rehabilitative care for older adults.
— What do geriatric medicine specialists treat? Geriatric physicians treat conditions that may commonly occur with aging, such as cognitive decline, mobility issues, chronic diseases and medication management. They often collaborate with other health care professionals, such as physical and occupational therapists, mental health professionals and social workers.
Hematologist
— What is a hematologist? Hematologists focus on disorders related to the blood and blood-forming tissues and organs.
— What do hematologists treat? Hematologists treat blood-related conditions, such as anemia, bleeding or clotting disorders and blood cancers.
Hospice and palliative medicine specialist
— What is a hospice and palliative medicine specialist? Hospice and palliative medicine specialists provide care and support to patients and their families as the patient navigates living with a serious or terminal illness.
— What do hospice and palliative medicine specialists treat? Hospice and palliative medicine specialists aim to prevent and alleviate suffering and to focus on improving quality of life for those with serious illness. This may include addressing physical, psychological, social and spiritual needs, such as administering pain management or end-of-life care. Common conditions treated include cancer, cardiovascular diseases and chronic obstructive pulmonary diseases, or COPD.
Infectious disease specialist
— What is an infectious disease specialist? Infectious disease specialists diagnose and treat infections caused by bacteria, viruses, fungi or parasites.
— What do infectious disease specialists treat? This medical specialist treats a wide range of infectious diseases, including HIV/AIDS, antibiotic-resistant infections and tuberculosis.
Geneticist
— What is a geneticist? These medical specialists diagnose and treat genetic disorders or conditions. Geneticists have special training in the study of genes and heredity.
— What do geneticists treat? Clinical geneticists care for patients in a clinical or research-based setting, and many geneticists counsel patients at risk for particular genetic disorders or cancers, such as sickle cell disease or hereditary breast and ovarian cancer.
Nephrologist
— What is a nephrologist? Nephrologists are medical doctors who treat disorders of the kidney.
— What do nephrologists treat? Nephrologists treat patients with kidney-related disorders, including kidney stones, chronic kidney disease and kidney failure. They often provide related medical management and may oversee dialysis, kidney transplantation and postoperative care, and managing diabetes or high blood pressure.
Neurologist
— What is a neurologist? Neurologists are specialty doctors who diagnose and treat disorders of the nervous system, including the brain, spinal cord and nerves.
— What do neurologists treat? Neurologists treat a range of disorders affecting the nervous system, including epilepsy, stroke, Alzheimer’s disease and other memory disorders, Parkinson’s disease and migraines.
Obstetrician-gynecologist
— What is an OB-GYN? An obstetrician-gynecologist specializes in the medical and surgical care of women related to pregnancy and childbirth and disorders of the female reproductive system.
— What do OB-GYNs treat? In addition to pregnancy and childbirth, OB-GYNs specialize in women’s health issues, such as menopause, contraception (birth control), infertility, endometriosis and polycystic ovarian syndrome, or PCOS.
Oncologist
— What is an oncologist? Oncologists specialize in diagnosing and treating cancer.
— What do oncologists treat? Oncologists manage several aspects of cancer care throughout the course of the disease and often consult with other specialists, like surgical oncologists, to develop treatment plans and provide care. These medical doctors often subspecialize in a particular type of cancer, such as breast oncology, neuro-oncology and radiation oncologists.
Ophthalmologist
— What is an ophthalmologist? Ophthalmologists are eye doctors who are medically trained to manage all aspects of eye and vision care, including medical and surgical treatments.
— What do ophthalmologists treat? General ophthalmologists treat diseases and disorders of the eye, such as cataracts, glaucoma, eye infections, diabetic retinopathy and refractive errors. They can also prescribe glasses and contact lenses.
Orthopedist
— What is an orthopedist? A general orthopedist, or orthopedic surgeon, specializes in disorders and injuries of the musculoskeletal system, including bones, joints, ligaments, tendons and muscles.
— What do orthopedists treat? Orthopedists may treat congenital deformities, traumatic or sports injuries, spinal disorders and degenerative diseases, as well as perform other types of orthopedic surgery.
Otolaryngologist
— What is an otolaryngologist? Commonly referred to as ear, nose and throat doctors, or ENTs, otolaryngologists are medical and surgical specialty doctors who diagnose and treat diseases and disorders of the head and neck.
— What do otolaryngologists treat? Conditions ENTs treat may include chronic sinusitis, allergic or non-allergic rhinitis, gastrointestinal reflux, tonsillitis and sleep apnea.
Physical medicine and rehabilitation physician
— What is a physical medicine and rehabilitation physician? Also referred to as physiatrists, these doctors focus on the functioning of the whole patient, rather than specific organs or systems, to manage pain and restore function.
— What do physical medicine and rehabilitation physicians treat? Physiatrists treat conditions which may limit a person’s ability to function, such as amputation, brain injury, cerebral palsy, Parkinson’s disease or a spinal cord injury.
Plastic surgeon
— What is a plastic surgeon? Plastic surgeons subspecialize in performing procedures that restore, reconstruct or replace physical defects or functions.
— What do plastic surgeons treat? Plastic surgeons handle reconstructive procedures, like cleft lip and palate repair or breast reconstruction after mastectomy, as well as cosmetic procedures, such as rhinoplasty or facelift.
Podiatrist
— What is a podiatrist? Podiatrists treat issues of the foot, ankle and lower extremities.
— What do podiatrists treat? Podiatrists manage conditions or injuries related to the lower extremities, such as sprains and fractures, plantar fasciitis, bunions, hammertoes and foot and ankle arthritis.
Psychiatrist
— What is a psychiatrist? A psychiatrist is a medical doctor who specializes in the evaluation and treatment of mental health, emotional and behavioral health disorders. They can prescribe medication and use other medical approaches to disease.
— What do psychiatrists treat? Psychiatrists see patients with mental, addictive and emotional disorders, such as psychotic disorders, mood disorders, anxiety disorders and substance use disorders.
Psychologist
— What is a psychologist? A psychologist is a mental health professional who treats mental, emotional and behavioral issues through therapy and counseling. Unlike psychiatrists, they cannot prescribe medication in most states. (Only Idaho, Illinois, Iowa, Louisiana and New Mexico allow psychologists with additional, specialized training to prescribe from an approved list of medications for certain emotional and mental health disorders, but they often collaborate with psychiatrists and other health providers.)
— What do psychologists treat? Similar to psychiatrists, psychologists work with patients with a variety of mental health disorders. They may also see people without clinical disorders who are feeling stressed or anxious to help them cope more effectively.
Pulmonologist
— What is a pulmonologist? Pulmonologists are medical specialists of the respiratory system.
— What do pulmonologists treat? Pulmonologists manage serious or chronic diseases of the lungs and airways, such as emphysema, bronchitis, pneumonia, asthma and COPD.
Rheumatologist
— What is a rheumatologist? Rheumatologists are specialized medical doctors who diagnose and treat disorders related to your joints, muscles and connective tissues.
— What do rheumatologists treat? Rheumatologists treat musculoskeletal diseases and systemic autoimmune conditions — referred to as rheumatic diseases — such as rheumatoid arthritis, osteoarthritis, lupus, fibromyalgia and gout.
Sleep medicine specialist
— What is a sleep medicine specialist? These medical specialists manage clinical sleep-related disorders and promote healthy sleeping habits.
— What do sleep medicine specialists treat? Sleep medicine specialists use clinical assessment and physiologic testing to diagnose, manage and prevent sleep disorders, such as insomnia, narcolepsy, parasomnias, circadian rhythm disorders and sleep-related breathing disorders, like obstructive sleep apnea.
General surgeon
— What is a general surgeon? General surgeons are trained in diagnosis, preoperative, operative and postoperative management in the nine primary components of surgery, which consist of the:
— GI tract.
— Abdominal and pelvic organs.
— Breasts, skin and soft tissues.
— Head and neck.
— Cardiovascular system.
— Endocrine system.
— Surgical oncology.
— Trauma.
— Critical care and emergency surgery.
— What do general surgeons treat? General surgeons can perform surgical procedures for a wide range of conditions, including appendectomies, hernia repairs and gallbladder removals.
Urologist
— What is a urologist? Urologists are doctors who deal with diseases of the male reproductive organs and the male and female urinary tract.
— What do urologists treat? Urologists may treat kidney stones, urinary incontinence and erectile dysfunction.
Do You Need a Referral to See Specialists?
Whether or not you need a referral to see a specialist depends on your health insurance plan
, your doctor or the type of specialist you’re trying to see.
Point of service, or POS, plans and health maintenance organizations, or HMOs, often require a primary care physician to work with your insurer for pre-approval to visit a specialist. The referral also likely needs to be for a specialist within your insurance network. If you’re unsure whether or not you need a referral, check with your insurance company first. Otherwise, your plan may not cover the care and you’ll get stuck with high out-of-pocket costs.
In addition to the patient’s health insurance coverage, symptoms, medical history and diagnostic testing and results, primary care physicians will likely take these factors into consideration when making a referral:
— Accessibility. It’s important for the specialist to be geographically accessible to the patient.
— Availability. Some specialists can take months to make an appointment with, so referring doctors take their availability into consideration.
— Coordination of care. When physicians are part of a broader health network, they’ll likely recommend a specialized doctor within the same network. One benefit is shared electronic medical records, which helps streamline follow-up coordination of care.
— Patient preferences or needs. Doctors may discuss options with a patient, taking their particular values, personal preferences or individual needs into account to ensure the referral aligns with their goals.
[Find: The Doctor That Is the Right Fit for You.]
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Types of Doctors and Medical Specialists: Which One Should I See? originally appeared on usnews.com
