When Doctors Play Hot Potato

It starts innocently enough.

“I think you should see a specialist.”

Fair enough. That’s what specialists are for.

But somewhere along the way, the referral turns into a game of medical hot potato.

The specialist says it’s something your primary care doctor should handle. Your primary care doctor says it’s outside their expertise and sends you somewhere else. That doctor orders a few tests, shrugs, and points you back to the first one. Before long, you’ve made more phone calls than anyone has made treatment decisions.

It’s like... will someone please take control here so it doesn’t have to be me? I mean, I’m the patient. I’m the one who’s sick. I shouldn’t have to be the one coordinating my own care, figuring out which doctor should be talking to which specialist, and trying to connect all the dots.

As for me, no one has really connected any of the dots. They’ve acknowledged that the dots exist, which somehow makes it even more confusing and frustrating.

It’s like they’re saying, “Yes, something is going on. We can see that.”

Okay... then what?

Who’s going to put those dots together? Who’s going to take ownership of figuring out what’s causing them? Who’s going to help me instead of sending me somewhere else?

My own experience with this is happening right now with pain management, which has become such a hot-button topic because of young doctors fear-mongering and gaslighting patients about pain medication when, frankly, the vast majority of legitimate pain patients aren’t the ones who caused the opioid crisis in the first place.

But I digress.

When I was diagnosed with a bone disease, my primary care doctor started me on pain medication. Then, because of one rule or another, she had to refer me to a pain management clinic over an hour away.

That arrangement worked just fine for more than three years.

Then my pain specialist announced he was leaving. The practice decided they were only going to continue treating certain types of pain patients. I wasn’t one of them.

So my options were basically, “Find another pain management doctor, go back to your primary care physician, or taper off the medication.”

Easy enough... right?

I went back to my PCP, who, by the way, agrees that I need the medication. She just doesn’t want to be the one prescribing it.

So her nurse started calling around trying to find another pain management clinic that would take me. They found one. Another hour away.

I went to the appointment only to find out they don’t treat patients like me who are on certain medications.

Great.

So back to my PCP I went.

Thankfully, she’s agreed to continue prescribing my medication while I’m searching for yet another pain management provider.

Do you see how frustrating this gets?

You never know if you’re going to have your symptoms under control and your quality of life in a good place, or if you’re going to be forced to live in pain because of rules and restrictions you had absolutely no say in creating, yet you’re the one who has to bear the consequences.

And then there’s the doctor who walks into the room, glances at your chart, and asks, “So... why are you here?”

Um... because my primary care doctor referred me?

Shouldn’t that be in my chart? Shouldn’t somebody have told you why I’m here before I drove an hour to get to this appointment?

Instead, I’m back to telling my entire medical history from the beginning for what feels like the hundredth time, hoping this time someone will connect the dots instead of handing me another referral.

There are hordes of patients stuck on this endless yo-yo of referrals.

Primary care. Specialist. Back to primary care. Another referral. Another specialist. Another waiting list. Another appointment. Another explanation of your medical history.

It just goes on and on, often with no one willing to take ownership of your care.

In the meantime, your quality of life hangs in the balance.

Every new referral brings a new wave of anxiety. Will this doctor actually listen? Will they dismiss me? Will they send me somewhere else? Will I end up right back where I started, left to fend for myself while everyone else passes the buck?

It’s exhausting. It’s frustrating. And it’s unsettling, to say the very least.

People’s lives aren’t just being inconvenienced by this game of medical hot potato. They’re being uprooted. Careers are interrupted. Families are affected. Mental health suffers. Pain goes untreated. Symptoms worsen. All while patients wait for someone, anyone, to simply say, “I’ve got this.”

Instead, it’s the mindless, endless hell of not being taken seriously, or having your illness dismissed as if it isn’t worth anyone’s time.

At its worst, people die while stuck in this medical purgatory. Others barely survive, fighting through each day while trying to hold on to some semblance of hope that the next appointment, the next referral, or the next doctor will finally have some answers.

So what can be done?

Hell if I know.

Because the last thing many patients feel they can do is tell a doctor how they think their care should be handled. There’s always that fear of being labeled “difficult,” “non-compliant,” or, if pain medication is involved, “drug-seeking.” Whether that fear is justified or not in any particular case, it’s real, and it changes how people advocate for themselves.

So instead, many of us bite our tongues. We nod. We accept another referral. We wait another three months. We tell our story all over again.

I don’t expect every doctor to have every answer. Medicine is complicated. Bodies are complicated.

But sometimes patients don’t need another referral.

Sometimes we need someone to say, “I don’t know what’s causing this yet, but I’m going to help figure it out.”

Those may be the most comforting words a doctor can say.

Because when everyone keeps passing the patient to someone else, eventually the only person left holding the hot potato is the patient.

And unlike everyone else...

We don’t get to pass it along.