I think that's just the difference between ER docs - who are, by their nature, generalists - and specialists. The main problem is that a specialist isn't being

I think that's just the difference between ER docs - who are, by their nature, generalists - and specialists. The main problem is that a specialist isn't being consulted during the ER visit for cases that are outside the scope of the ER docs' knowledge. I think if the ER docs are at the point of saying "yes, we can 'kind' of fix it but not back the way it was" that should trigger an automatic specialist referral.