I work in a small ophthalmology office (one doctor and 6 girls including me). I enjoy all of my co-workers but my one complaint is occasionally the patients. So many people just do not know what their insurances require. When you tell them they needed to bring a referral it can get nasty at times. Sometimes they take the day off and come in and we have to turn them away because of no referral. We explain that it is YOUR insurance and up to you to understand what they require. We do try to confirm appointments a day or two before and leave messages on their machines like "if your insurance requires a referral, make sure you bring it with you." We have even had people not show up because we didn't "remind" them. Of course if the person is not home and has no answering machine what are we to do. Personally I don't think it should be our problem. I think that by the time people reach adulthood they should be able to be responsible for themselves.