A patient should be referred to a specialist when indications are present. Failing to refer a patient to a specialist can result in malpractice litigation.

The basis for a lawsuit may be:

(1) delay in diagnosis

(2) inappropriate management

(3) unnecessary complications


Factors that would support the litigation:

(1) indications for referral in accepted guidelines

(2) evidence that the condition is outside of the physician's scope of practice

(3) failure to recognize the significance of certain findings


Factors that need to be clearly documented in the medical record:

(1) any shared decision making with the patient

(2) any barriers to referral (such as insurance restrictions)

(3) any other reasons for not referring

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