In Canada, the primary care physician (GP) acts as the gatekeeper for access to specialists. This is to minimize inappropriate referrals and unnecessary referrals for problems that the primary care physician is comfortable treating. The GP is also responsible for doing the preliminary tests and compiling a referral letter. The GP will let the patient know when a referral to the specialist becomes necessary. Some people have a preference of the specialists that they want to see, the GP will consider if the specialist is appropriate for the problem. From time to time, a patient may request an opinion from a specialist even though such referral is deemed not necessary. On a case-by-case basis, this will be seriously considered if such referral will add any benefit to the treatment outcome.

Depending on the urgency of the problem and the availability of the specialist, the appointment wait time can take from several days to two years. Most specialists will contact the patient directly to book the appointment. It is important that your voicemail is activated to receive these calls and that your phone does not block unknown phone numbers. Some specialists will notify patients through email. Please give the courtesy of notifying the specialist if you change your mind about attending the appointment or needing to reschedule. Most specialists will charge a no-show fee for missed appointments.

There is no interpreter in most specialists' offices. It is important that you bring an English-speaking interpreter with you if needed.

Usually, we receive reports from the consultant specialists 1-2 weeks after your visit. There is no need to return to us to discuss the report if you are satisfied with the answer and treatment you received from the specialist. If you have a problem with the specialist’s recommendation and treatment, please contact that office directly for clarification and there is no need to get a referral from our office if your visit is within six months.

Occasionally, a specialist will advise you to return to see us for follow-up if that is the appropriate course of action.