I've never seen the problem with referrals. If you have a regular doctor, they will refer you wherever you want. We can pick up the phone and call out regular MD and he will make a referral "right then" with no visit.
He's talking about ending up "out of the network" which means you have to pay them because the insurance won't. It was explained to me, this is a much larger problem in larger areas, because there are simply more outfits (hospitols etc) as well as various doctors, and therefore you can end up "out of network." I've checked, and anyone I've been dealing with is "in" around here.
This appears to be a much worse problem in big urban areas
