Orthopedist will examine knee, but not hip. End of absurd regulations?

There is a regulation in the Polish healthcare system that generates unnecessary queues, increases costs and frustrates patients every day . It concerns referrals to specialists. If during a visit to a dermatologist, orthopedist or cardiologist, a patient reports an additional symptom – not previously included in the referral – the doctor has no right to treat him. Does it sound absurd? That is how the law currently in force works.

Petition BKSP-155-X-446/25 addressed to the Sejm postulates a change in these regulations. Check why this topic may also concern you and how a change in the law could improve the efficiency of the entire healthcare system.

The author of the petition – citing the Constitution of the Republic of Poland and the Act on Petitions – demands a change in the regulations that currently limit the ability of medical specialists to treat conditions other than those indicated in the referral (ICD-10 code) . The proposal assumes that if a patient reports other conditions during a visit that fall within the scope of the doctor's specialization, the doctor should have the right to diagnose and treat them without having to present a new referral.

The current law (Act of 27 August 2004 on healthcare services financed from public funds) does not provide for flexibility. In practice, this leads to:

• waiting many months for subsequent visits,
• the need to return to the primary care physician for a new referral,
• increased system costs (further consultations, duplication of documentation),
• delays in diagnosis, which may result in deterioration of health.

The petition cites specific real-life examples that illustrate how rigid regulations can harm patients:

• Dermatologist: Patient with skin redness cannot be tested for melanoma – further referral required.
• Orthopedist: The doctor cannot examine the hip if the patient comes in with knee pain – even though it's the same specialty.
• Neurologist: Migraine can be treated, but hand numbness cannot be treated unless it is on the referral.
• Endocrinologist: Thyroid nodules are not diagnosed if the referral is only for hypothyroidism.
• Cardiologist: Arrhythmia may be missed if the patient has been referred only for diagnosis of hypertension.

Although the applicant does not present a bill (which is a common reason for rejecting a petition), he indicates possible legislative solutions, such as:

• adding a provision to Article 57, paragraph 1 of the Act on Healthcare Services, enabling specialists to treat other conditions within the scope of their specialisation;
• extending Article 6 of the Patient Rights Act to formally guarantee the patient the right to comprehensive treatment by a specialist without new referrals.

This is a small change from the legislator’s point of view, but a fundamental one for the patient.

The World Health Organization (WHO) and modern healthcare systems promote a model of integrated healthcare in which the patient is not treated through the prism of a single symptom, but holistically – as a whole organism.

The regulations in force in Poland are at odds with this approach. The petition is therefore part of a global trend of simplifying access to diagnostics and treatment.

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