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A gatekeeper is the first health care professional a patient sees regarding a medical issue. Gatekeepers diagnose listen to patient complaints and either treat them or, in the case of more complex problems, refer them to other specialized health care professionals who can help. Gatekeepers are usually primary care physicians, physician assistants, or ARNPs.
The practice of primary care physicians acting as Gatekeepers became part of the modern model of managed health care in the United States. This practice has now spread throughout the world.
As with other gatekeepers in other fields, gatekeepers in the health care can allow or deny their patients access to others in the health care system. It’s up to them who they refer their patients to, and thus the care that they receive. Although it is also important to note that patients always have the right for a second opinion if they feel that they are not getting the care or tests they need.
Patients do not simply pass through the health care system. The gatekeeper remains a touchstone throughout a patient’s care. If their healthcare complaint is simple, such as a minor sexually transmitted infection, the gatekeeper will most likely diagnose and treat the problem. If lab tests are required to confirm a diagnosis, the gatekeeper will order these tests and receive the results. In the case of more serious health problems, the gatekeeper will authorize hospital stays as required and liaise with hospital staff.
People typically develop relationships with their healthcare gatekeepers. If they fall ill again or develop recurring symptoms, as can happen with some sexually transmitted infections including herpes, they get back in touch with their gatekeeper. Patients who use the same gatekeeper usually receive more consistent care than people who approach different health care professionals with their problems.
Using gatekeepers doesn’t just make sure patients receive the best care. It also reduces costs by ensuring patients do not organize tests or treatment they don’t need. Primary level health care, tests, and diagnosis are usually more affordable than secondary and specialty health care services. Gatekeepers only approve these more expensive services if they’re absolutely necessary.
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