In most managed care systems (my ex is a big dog case manager), referrals have to come from the PCP's office--they're the gatekeepers. So, when you need a consult with a specialist , you have to go through the referral clerk at the PCP's office, even if some other specialist wants you to go.

So, buy a big box of chocolates, take it to the referral coordinator, and ask her to help....whenever you need a different doc, this is the person who has to arrange it. Befriend her...babysit her kids for free...pay cash... anyway, you get the idea!

DJ

PS. Good Luck and HNY!