Two ear problems you may not need to refer. Otitis externa and bullous myringitis.

Primary care physicians are being forced to broaden the scope of their practice because of the financial restraints placed on them by managed care. Common otologic conditions such as otitis externa and bullous myringitis, which are often referred to otolaryngologists, can be promptly diagnosed and treated by primary care physicians. Referral to a subspecialist is indicated when symptoms persist despite treatment and when the cause of ear pain remains unexplained after thorough evaluation.