S: Mr. D is a 40 yo male with pseudohypoparathyroidism coming in for referral for hip replacement surgery.
O: Hip X ray showed severe osteoarthritis
A: Hip replacement at 40 years is too early, since the life of new hip joint is only a few years. But since patient is debilitated from osteoarthritis, will refer to orthopedics. Some insurances require having to go to primary care to be seen by a specialist- that’s an important SDH.
P: Will be cognizant of the fact that some patients absolutely need a referral from us to be seen by a specialist, due to the type of insurances they carry.
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