I called Mayo Clinic today to make an apt just to check my j-pouch because when I was their in 9/2013 the dr said I should be checked every few years. Wanted to make an appt in 9/2016 but was told that I need a referral since I haven't been there in 3 yrs I am considered a new patient. I don't try to make many dr visits anymore since I have been in good shape since my surgeries. Now they want my primary care dr to call in the referral. I really don't have a primary care dr since in my area it seems that they just keep coming and going and I really don't get paying a dr to see me that can't do anything for me but take my money to call into mayo's with referral when there is nothing wrong with me. Well probably will not be going to be checked out but did tell my husband that if I am ever really sick due to GI issue to try and just take me to ER at one of mayo's hospitals and hopefully they will see me then. Mayo's is a 6 hour drive for me. So much for trying to keep things checked.
There really isn’t a need to go to Mayo for a pouchoscopy if you are not experiencing anything that would suggest a pouch problem. A good GI in your area should be able to do the exam and then refer you to Mayo only if he/she finds something that cannot be handled locally. My condition requires annual scoping and I went to Mayo only 2 times in 30 years when my GI’s findings needed a second opinion.
Still, even if you go locally, you will likely need a referral from a primary MD (unless you have a PPO that allows self referrals to a specialist). Once you are established, you don't need a referral. You do need to retain the relationship, however.
It is nice to have a primary MD for all the usual stuff (like the occasional non-GI illness).