Many of us remember when a dermatology practice was cash only, and $5 cash was considered appropriate for a specialist. The general practitioner received $2 for an office visit and $4 for a home call. If you recall those days, “dearie you are much older than I.” 1
Not so long ago, the practitioner was confronted with obtaining a referral from the Health Maintenance Organization (HMO) in order to see the patient. Some plans permitted only four such referrals for specialists, annually, so the patient, who might have had a visit or two for gastritis and a similar number of visits for an eye infection, was just out of luck if poison ivy appeared on the scene. 2
Parish, Lawrence Charles; Parish, Jennifer L.; Lambert, W. Clark; and Ciferni, Carmela, "The Practice of Dermatology Ain't What It Used To Be: The Preauthorization Catastrophe." (2019). Department of Dermatology and Cutaneous Biology Faculty Papers. Paper 116.
This article is the authors' final version prior to publication in SKINmed, Volume 17, Issue 3, May-June 2019, Pages 152-153.
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