Adolescent Subspecialty Referrals: Too Much Time and Cost?

An increasing focus on cost of care in medicine has resulted in heavier scrutiny of care expenditure. Patients are referred to adolescent medicine for a variety of reasons and in our experience, referring providers may have ordered testing prior to the first visit that is either incomplete or in excess of what is needed for diagnosis. This may increase the cost and burden of care through extra specialist visits or unnecessary diagnostic testing. The purpose of this study was to examine the number of tests performed and the number of specialist clinic visits prior to diagnosis in patients with irregular menses or secondary amenorrhea and to see if differences exist based on visit payer.