HMO, PPO, BS

I just got back from an appointment with a pediatric orthopaedic (PD), which required me to have a referal faxed to their office and I also had to bring a copy. In addition, I had to HAND deliver a note on very bright paper that basically told the doctor not to do anything without a referal from Quinn's primary care physician (PCP).
While at the doctor I find I need to contact the PCP to get a referal for an xray. Although, they do xrays at this office, since we have a HMO, we are not allowed to use that service. We have to go somewhere else after getting a referal from the PCP. So, the PD had to write a note asking the PCP for an xray referal. However, if we had a PPO plan we could get the xrays done in the office. We could have had them today.
Also, the PD believes Quinn needs braces and so I need to take him to a Prosthetist and Orthostist (PO). In order to do that, I need a referal from, yes, that's right, the PCP. So, I have to call the PCP and request a referal to a PO, whose name and number I already have. I cannot make an appointment with the PO until I receive a referal from the PCP. If you ask me it's all just a bunch of BS.