Services provided by medical specialists who generally do not have first contact with patients (eg, cardiologist, urologists, dermatologists). In the US, however, there has been a trend toward self-referral by patients for these services, rather than referral by primary care providers. This is quite different from the practice in the UK, for example, where all patients must first seek care from primary care providers and are then referred to secondary and/or tertiary care providers, as needed.
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