In a managed care system, the primary care physician who is the first doctor the patient seeks for nonemergency care and determines whether referral to a specialist is medically appropriate. The gatekeeper also controls patient access to diagnostic testing services. In some managed care plans, a nurse practitioner or physician assistant is appointed to this role. Also called primary care physician and referral provider .

Process in which a managed care system’s gatekeeper provides the initial patient care, schedules diagnostic testing services, and refers patients to specialists when necessary.