Definition - What does Gatekeeper mean?

A gatekeeper is a healthcare provider who is the first point of contact for patients, and who decides what level of care the patient will get next. Oftentimes, primary care physicians are gatekeepers in the healthcare system. In many health insurance plans, patients can only see specialists with a referral from a gatekeeper.

Insuranceopedia explains Gatekeeper

Gatekeepers serve a very important role in the healthcare system. This is because they are not only the first line of defense when it comes to treating an illness or an injury in many cases, but they also serve the crucial role of triaging patients. Essentially, they figure out what is wrong with the patient, and who they need to see next in order to get the issue resolved. Therefore, gatekeepers are very important both for patients and for the healthcare system.

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