Shane,
I can only speak for myself, but with my insurance, an hmo type, all referrals, etc. have to come from your primary care physician(PCP). My PCP knows everything about my health problems, etc.(except that I sometimes use OP's of course). He is the one who referred me to all specialists that I have seen, i.e.: rheumatologist, urologist, neurologist, et al. I was honest on my online form with his info. Just don't want him to know about the OP useage for obvious reasons. He is rather old-fashioned and would equate OP's with drug dealers. He would not understand the concept. Besides all of that, he is in Iraq. Does this help answer your question??

Folksong