When your family doctor or general practitioner refers you to a specialist, it means that your medical problem requires specialized care and expertise that is beyond the scope of your primary care physician. However, understanding how the referral system works in Alberta and Edmonton can be challenging, especially for people who are new to Canada or unfamiliar with the Canadian healthcare system. Fortunately, there is a clear and organized system for processing referrals that is designed to ensure patients have timely access to specialized medical care.
This article will provide a detailed guide on what to do when your doctor recommends a specialist, including information on how to understand a referral, how the registration process works, what to expect in terms of wait times, how to check the status of your referral, and how to consider alternative options if you need additional help. By understanding this process, you can better navigate the healthcare system and get the specialized care you need.
Understanding Specialist Recommendations and Referrals
When a doctor recommends a specialist
There are many medical situations when your family doctor may recommend that you see a specialist. Specialists are doctors who have received special training and experience in a specific field of medicine, such as cardiology, dermatology, neurology, orthopedics, psychiatry, and many others. Your doctor may recommend a specialist for several reasons:
To diagnose complex problems: If you have symptoms or health problems that are difficult to diagnose, your doctor may refer you to a specialist who has more experience and specialized equipment to make the correct diagnosis.
To treat specialized conditions: Some medical conditions require specialized treatment that only a specialist can provide. For example, if you have a serious heart condition, you will need a cardiologist to manage your condition.
For surgical treatment: If you need surgery, your doctor will refer you to a surgeon, a specialist in a specific field of surgery.
For a second opinion: If you want a second opinion about your medical care or diagnosis, you can ask your doctor for a referral to another specialist for a second opinion.
For ongoing management of chronic conditions: If you have a chronic condition that requires specialized management, such as diabetes or hypertension, your doctor may recommend a specialist to manage your condition.
What a referral includes
A referral is a formal written recommendation from your doctor to a specialist for consultation and treatment. When your doctor issues a referral, it must include important information that helps the specialist understand your medical situation and evaluate you correctly:
Patient information: The referral includes your full name, date of birth, personal health number (PHN), and contact information.
Physician information: The referral includes your doctor's name, phone number, and clinic address.
Specialist information: The referral includes the name of the specialist or specialty to which you are being referred and the address of the specialist's clinic.
Purpose of the referral: The referral should clearly describe the reason you are being referred to a specialist and what the specialist should do (e.g., medical opinion, diagnosis, treatment).
Clinical information: The referral includes detailed information about your medical history, current symptoms, laboratory test results, X-ray results, and other relevant clinical data.
Urgency: The referral indicates the urgency of your case—whether it is a routine referral or requires expedited care.
Referral processing in Alberta and Edmonton
FAST - Facilitated Access to Specialized Treatment
One of the most important systems for processing referrals in Alberta and Edmonton is the FAST (Facilitated Access to Specialized Treatment) program. FAST is a centralized access and intake program for certain surgical referrals. The program was designed to improve patient access to specialized care by centralizing referral processing, ensuring referral completeness, and distributing referrals to specialists.
What specialties does FAST cover?
FAST covers several surgical specialties in the Edmonton area, including general surgery, orthopedics, vascular surgery, gynecological surgery, and others. Separate processes exist for some specialties, such as thoracic surgery, thoracic oncology, and urology.
How FAST works
When your doctor issues a referral, they send it to the FAST team by fax. The FAST team receives the referral, checks it for completeness, and sends it to a specialist or network of specialists. If your doctor has not requested a specific specialist, the FAST team may direct the referral to the specialist with the shortest wait time. FAST also tracks wait times for each specialist and can allocate referrals accordingly.
Fax numbers for FAST in Edmonton
Depending on the specialty, your doctor will send the referral to different fax numbers:
- General surgery: 780-670-3224
- Orthopedics: 780-670-3221
- Vascular Surgery: 780-409-0607
- Gynecologic Surgery: 780-409-0607
Contact the FAST team
If you have questions about your referral, you can contact the FAST team in Edmonton:
- Phone: 1-833-553-3278, extension 2, Monday through Friday from 7:30 a.m. to 3:45 p.m.
- Email: [email protected]
- Website: ahs.ca/FAST
Alberta Referral Directory (ARD)
The Alberta Referral Directory (ARD) is the official online source for information about specialists and services that accept referrals in Alberta. The ARD simplifies the referral process by providing physicians and patients with clear and organized information about referral processes, requirements, and specialist contact information.
What you can find in the ARD
The ARD contains profiles of health care professionals and services with information about their referral links, attachment requirements (e.g., required tests or information), approximate wait times for consultations, and patient eligibility requirements. The ARD also lists private services that accept referrals.
How to use ARD
You can access ARD on the Alberta Health Services website or through your doctor. Your doctor will use ARD to get information about referral requirements for a specific specialist before sending a referral.
Alberta Netcare eReferral
Alberta Netcare eReferral is an electronic system within the Alberta Netcare system that allows doctors to create, send, and track referrals. eReferral uses existing patient information to fill out forms, verify details, and track referrals to appointments.
How doctors use eReferral
Your doctor will use eReferral to send a referral to a specialist. The system allows the doctor to quickly fill in the necessary information, attach test results and documentation, and send the referral to the specialist.
How patients can check the status of their referral through eReferral
As a patient, you can access information about the status of your referral through the eReferral system via My Personal Records (MPR) or MyAHS Connect if you have accounts in these systems. The information available to patients includes the referral date, referring physician, reason for referral, and current referral status.
How the referral process works
Step 1: Discussion with your doctor
The first step in the referral process is a discussion with your doctor. Your doctor should discuss with you the reason for the referral, what problem you are concerned about, and how a specialist can help. This step is important because your doctor needs to make sure that you understand the reason for the referral and agree with it.
During this discussion, your doctor should also inform you of any possible fees that may not be covered by Alberta Health Services. If you have private health insurance, you can ask if your insurance will cover the cost of the specialist.
Step 2: Issuing a written referral
After discussing with you, your doctor issues a written referral. The referral must include all the necessary information described above and must be sent to the specialist in the proper manner. If your doctor needs an urgent consultation, they must contact the specialist directly by phone and discuss your case.
Step 3: Processing the referral by the specialist
When the referral arrives at the specialist's office, it is processed. The specialist evaluates the referral to ensure that it is appropriate for their practice and expertise. The specialist should contact you within a reasonable time that is appropriate for the urgency of your case, but no later than 14 days from the date the referral is received.
Step 4: Scheduling an appointment
Once the specialist has accepted your referral, their office will schedule an appointment with you. You will receive a letter with the date, time, and location of the appointment, as well as detailed instructions on what you need to bring and prepare. If you are unable to attend the appointment on the proposed date, you can contact the specialist's office and request a reschedule.
Step 5: Attending the Specialist Appointment
When the day of your appointment arrives, it is important to arrive on time, bring all necessary documents and test results, and be prepared to discuss your medical history. During the appointment, the specialist will assess your condition, may perform additional tests or diagnostics, and will give you recommendations for treatment.
Step 6: Specialist's report to your doctor
After you see the specialist, they must send a written report to your doctor within 30 days. The report should include information about what was done during the consultation, the diagnosis, treatment recommendations, and recommendations for further treatment.
Wait times for specialist consultations
Average wait times in Alberta
Wait times for specialist consultations in Alberta vary significantly depending on the specialty. Studies show that the average wait time for a specialist consultation in Canada is approximately 11-15 weeks. However, in some specialties, wait times can be much longer.
Wait times by specialty
According to research and data available in Alberta:
- Internal medicine: The average wait time is 23 weeks
- Otolaryngology (ear, nose, and throat treatment): The average wait time is 53 weeks
- Urology: The average wait time is 36 weeks
- Orthopedics: The average wait time is approximately 40-60 weeks
Factors affecting wait times
Wait times depend on several factors:
- The number of patients waiting for a consultation
- The availability of the specialist and their work schedule
- The urgency of your case
- The type of specialty (some specialties are in high demand)
How to reduce waiting times
There are several ways you can reduce your waiting time for a consultation with a specialist:
Choosing the next available specialist: If you are willing to see the first available specialist instead of a specific specialist, you may be offered an appointment sooner. The FAST system, for example, assigns referrals to the specialist with the shortest waiting time, if you wish.
Check for other locations: If there are several offices of a specialist in your area, one office may have a shorter waiting time than another. You can ask if appointments are available at other locations.
Seeing a private clinic: If wait times in the public health system are too long, you may consider seeing a private specialty clinic. However, private consultations can cost a significant amount of money, with some specialties costing $160 to $210 per consultation or more.
Checking the status of your referral
My Personal Records (MPR)
Starting in April 2025, people in Alberta can check the status of their referrals through the My Personal Records (MPR) system. MPR allows patients to access important information about their referrals, including the referral date, referring physician, reason for referral, and current status.
How to access MPR
To access My Personal Records, you will need to create an account through the Government of Alberta website. Once you have created an account and logged in, you will be able to view all of your referral information.
Referral statuses in MPR
In MPR, you will see different statuses for your referral:
- Under review: Your referral is being clinically reviewed by a specialist team
- In progress: The specialist team is working on your referral
- Appointment scheduled: You have an appointment scheduled with a specialist
- Waiting for appointment: You are on the waiting list for an appointment
- Rejected: The specialist has rejected your referral
- Cancelled: Your referral has been cancelled
MyAHS Connect
MyAHS Connect is another online portal for patients in Alberta where you can check information about your referrals. On MyAHS Connect, you can see the same referral as on MPR, but in some cases, they may have different information. It is recommended to check both systems.
Contacting a Specialist
If you have not received an appointment within a reasonable amount of time or have questions about the status of your referral, you can contact the specialist's office directly. The specialist's office should provide you with information about the status of your referral and let you know when you can expect an appointment.
Health Link 811
If you are having difficulty obtaining information about your referral or need help navigating the health care system, you can call Health Link 811. Health care navigation specialists can help you find out the status of your referral and provide recommendations on next steps. The service is available 24 hours a day, 7 days a week, and offers services in more than 170 languages.
Preparing for your specialist appointment
Materials to prepare
Before you see a specialist, you should prepare several materials and documents:
Medical records: Gather all relevant medical records from your doctor, including records of previous visits, diagnoses, and treatments.
Test results: Bring all lab test results, X-rays, magnetic resonance imaging (MRI) scans, and other diagnostic tests that have already been performed.
Medication list: Prepare a complete list of all medications you are taking, including prescription medications, over-the-counter medications, and supplements.
Insurance: Bring your health insurance card and any other relevant insurance (if you have private insurance).
List of questions: Prepare a list of questions you want to ask the specialist.
Understanding expectations
It is important to understand what you can expect from your first appointment with a specialist:
Medical history: The specialist will ask you many questions about your medical history, symptoms, favorite medications, and lifestyle.
Physical exam: The specialist will perform a physical exam to assess your health.
Diagnostic tests: The specialist may order additional diagnostic tests or studies to confirm the diagnosis.
Discussion of treatment options: Based on their assessment, the specialist will discuss various treatment options with you and recommend the best approach for you.
Report to your doctor: The specialist will send a written report to your doctor with the results of the consultation and recommendations for further treatment.
Alternatives and private specialists
Private specialists
If waiting times in the public healthcare system are too long or if you would prefer a private consultation, you may consider seeing a private specialist. Private specialists provide consultation services for a fee.
Costs of private consultations
The cost of a private consultation with a specialist varies depending on the specialty. Typically, private consultations cost between $160 and $210 per consultation and up. Some private specialists may also offer package prices for multiple appointments.
Insurance for private specialists
Depending on your private health plan and your administrator, you may be covered for part of the cost of a private consultation. It is recommended that you check with your insurance company to see what is covered.
Obtaining a referral from a private specialist
It is important to note that even if you are seeing a private specialist, you may still need a referral from your family doctor for some services. In addition, if you then need treatment through the public health care system, you may need a new referral from your family doctor.
Traveling outside of Alberta for specialized care
In some cases, you may want to see a specialist in another province or even internationally. If you are considering this option, it is important to be aware of the potential costs and insurance coverage.
Insurance for treatment outside Alberta
If you need treatment outside Alberta through a private clinic or service that is not covered by the Alberta Health Care Insurance Plan (AHCIP), you must obtain prior approval from Alberta Health. Before booking services outside of Alberta, you must contact Alberta Health's Out-of-Province/Out-of-Country Unit at [email protected] to find out about coverage restrictions and limitations.
Seeking a second opinion and changing specialists
Right to a second opinion
According to the College of Physicians & Surgeons of Alberta (CPSA) standards of practice, you have the right to request a second opinion about your treatment. Your doctor must respect your reasonable request for a referral for a second opinion.
How to request a second opinion
If you want a second opinion about your treatment or diagnosis, you can ask your doctor for a referral to another specialist. Your doctor must provide you with a referral for a second opinion without question or delay.
Changing specialists
If you are dissatisfied with the work of the specialist you are seeing, you can ask your doctor for a referral to another specialist. However, it is important to make sure you have a valid reason for changing specialists, as this may delay your treatment.
Reasons for changing specialists may include:
- Dissatisfaction with the quality of service
- Communication problems with the specialist
- Adverse reactions to the recommended treatment
- Need for specialized expertise that another specialist possesses
Specialist refusal of referral
When a specialist may refuse a referral
In some cases, a specialist may refuse your referral. This can happen for several reasons:
The referral is not appropriate for the specialist's practice: If your medical problem is not within the specialist's area of expertise, they may refuse the referral.
Incomplete information in the referral: If the referral does not contain enough information for the specialist to assess your situation, the specialist may request additional information before making a decision.
The patient is already seeing the specialist: If you are already seeing this specialist for ongoing care, the specialist should not require a new referral for an additional consultation.
Not an urgent situation: Some specialists may have a long waiting list for routine consultations, and they may decline your referral if it is not considered urgent.
What to do if a specialist declines a referral
If a specialist declines your referral, they must provide a reason for the decline and, if possible, suggest alternative treatment options. Your doctor can then try to refer you to another specialist or discuss alternative treatment options with you.
Conclusions about referrals to specialists in Edmonton
The process of obtaining a referral to a specialist in Edmonton and Alberta is well organized and structured. When your doctor recommends a specialist, it is important to understand the reason for the referral, how the referral is processed, how long you will have to wait for an appointment, and how to check the status of your referral.
Although wait times for specialist consultations in Alberta can be long, depending on the specialty, there are several ways to reduce your wait time or explore alternative options, such as private specialists. If you have questions or concerns about your referral, you can always contact your healthcare team, the specialist's office, or Health Link 811 for assistance and guidance.
By understanding this process and being an active participant in your healthcare, you can ensure that you receive the specialized care you need in a timely and effective manner.