Kay: What is the structure of medical care at a local level in the US? In particular, what is the equivalent of a UK general practitioner?
We call them GPs, too. Or family doctors. The way most HMOs work (Health Maintenance Organizations, private insurance supplied by corporate employers), you have to choose a GP who's on their list of "participants" or whatever, and that GP acts as a gateway to the rest of your medical needs. If you know you need brain surgery, you'll have to go to your GP, get the GP to recommend a brain specialist (who's also recognized by the plan), who will then recommend further specialists in the particular kind of brain surgery you need.
Emergency room visits are a little different, and different kinds of insurance plans (EPOs, PPOs) will have different levels of support for, say, the doctor of your choice vs. the ones on their list. And some doctors' billing offices will refuse to deal with some insurers (so, like within my company's HMO, the actual sub-contracted insurer changed from United to FiServe, and our family pediatrician almost dropped us because, although the big umbrella insurer didn't change, the specific little sub-insurer did, and the new one has a notoriously messed-up billing system.)
That's probably more than you need to know. |
