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Understanding “Failure to Refer” Claims

Serving Clients throughout New York City for Close to 30 Years

In today’s struggling economy, people all over the country are struggling to make ends meet and keep their businesses growing. Hospitals and private practices are no different. Many are fighting for patients so that they are able to financially stay afloat. This can be a good thing if it causes them to increase the quality of their services, but it could also have a darker side.

Some patients need to be referred to another physician, but the doctor they visit is unwilling to lose their business; sending them to a specialist or for a second opinion means that they are going to lose money. Not only does this mean that they do not have the patient’s best interests as their goal, but it could lead to serious and even fatal consequences.

If your doctor has failed to refer you accordingly to another physician, contact The Law Offices of Joseph Lichtenstein. Our New York City medical malpractice attorneys can explain to you the legal process and provide representation.

The Referral Process

When a person visits their primary care physician, a number of different scenarios could play out. First of all, they could be diagnosed and treated without needing to be referred to another physician. They will most likely be sent to a pharmacy to pick up their prescription medication, but most patients choose their own pharmacy.

If the physician does not feel confident that they can treat the patient, they may refer them to another facility or specialist. In fact, 70% of specialist referrals come from a primary care doctor. In order to protect patients from being taken advantage of in the referral process, doctors are not allowed to refer them to facilities by which they would gain financially. The goal of this is to keep self-interest out of the equation when referring a patient. One exception to this law, however, is in regards to radiology centers. Doctors are allowed to refer patients to imaging machines which they own.

Other types of referrals a primary care physician could make are to diagnostic labs for lab tests, an independent specialist group, a subspecialist, a hospital, or a specialist from the hospital. To learn more about the referral process, please see this helpful graph published by the Wall Street Journal.

When just focused on monetary gain, the referral process can be compromised. Hospitals and other specialists may fight to get business by suggesting unnecessary treatments. However, the opposite could also be true, as mentioned earlier. Physicians may choose not to refer a patient because it means losing business, even if this is considered as Medical Malpractice.

The Possible Dangers of Failing to Refer

How could this be a problem? Perhaps nothing speaks as loudly as real life examples of what could happen when a doctor fails to refer. A 42-year-old husband and father of four visited an internal medicine physician complaining of pain in his chest. The doctor told him it was a torn muscle in his chest and prescribed him pain medication for the symptoms.

One year later, he died when his heart valve failed. If the physician had referred him to a heart specialist, they would have discovered that he had a leaky heart valve and would have been able to receive a replacement. This father would not have died at such a young age had he been referred.

In another case, a 22-year-old man filed a lawsuit against his two internists following their failure to refer him to a liver specialist. At the age of 14, he had run into a basketball pole and had suffered from elevated enzymes in his liver ever since. They failed to diagnose that he had Wilson’s disease, which led to cirrhosis of 60% of his liver. He now may need to have a liver transplant in the future.

Those who believe that they were treated negligently by a physician failing to refer them should contact our medical malpractice attorneys at the Law Offices of Joseph M. Lichtenstein, PC. If you are suffering because a physician failed to refer you to a specialist, you could be entitled to compensation.

The Law Offices of Joseph Lichtenstein provides legal services to most areas around New York City, including the Bronx, Queens, Brooklyn, and Manhattan, as well as Long Island, Westchester, Suffolk County, and Nassau County. We offer New York communities our expertise as birth injury lawyers, among other legal services. For more information on our services, or to schedule a consultation, visit our contact us page or call us at (888) 392-3104.

The Law Offices of Joseph M. Lichtenstein, PC represents injured victims or families in New York that have lost a loved one in all types of claims resulting from medical negligence.

New York City Medical Malpractice Lawyers - 60+ Years Experience!

Call Us Today: (516) 873-6300

With Offices Located In The Following NYC Metro Areas:


77 Water Street
8th Floor
New York NY 10005
Phone: (646) 722-4329
Mobile: (516) 547-5978


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Bronx, NY 10470
Phone: (718) 324-0200
Mobile: (516) 547-5978


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Brooklyn, NY 11201
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Long Island

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Mineola NY  11501
Phone: (516) 873-6300
Mobile: (516) 547-5978


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Suite 2-2
Ossining, NY 10562
Phone: (888) 392-3104
Mobile: (516) 547-5978

medical malpractice lawyer credentials in nyc