<<Disclaimer: Verify this information before applying it to your situation.>> Dear Friends, One week ago my husband's company gave us two weeks to decide whether we would keep our current health coverage with steep financial penalties, or switch to managed care. With the latter we would need to select primary care physicians from their list. I called the office of a doctor who appeared to be a good choice after some informal research. She is a member of a highly respected group at one of the most highly respected hospitals in the Boston area. My questions revealed they do not give introductory appointments and all referrals are only to doctors in the same hospital. Now, my allergist, the wonderful Dr. Stuart Rhein who diagnosed my cd, is at Metrowest; my terrific gynecologist is at Brigham and Women's; and the world-renowned doctor who helped me avoid an unnecessary biopsy and does my yearly mamogram is at The Faulkner. The only reason I can see for all referals to be made within the hospital is financial gain. I've also heard rumors that HMOs pay cash awards to their doctors when they do some things that save the HMO money but may not be in the client's best interest. Is this old hat? I am outraged. Are you? You can guess how I feel about not being allowed to talk to a new doctor. Maybe I will make an appointment for something minor that wouldn't usually send me to a doctor, in order to meet her. (At the risk of being labeled a hypochondricac! ... all those years of being told the pain that made me wish I were dead and turned out to be cd, something perfectly avoidable, was all in my head....) And I will pay extra to continue seeing my regular specialists. I wonder what happens to people who can't afford to pay extra. Mara in MA, USA