@fiesty76 Sometimes you just have to be blunt with doctors but it's always best to have a planned approach when discussing a referral request. I found a really good description of how to approach your doctor but it does come from a legal website. It's a one page read with some good thoughts and questions which should not upset your doctor. Excerpt from the page with the link under it.

"As a patient, here’s what you can do to prevent referral issues:

Don’t accept the first answer. We often back down when our doctor doesn’t seem to be concerned and minimize what is happening with us medically. After all, they have the medical degree. Understand you are in the best position to know what is happening with your own body and when it is unusual or concerning.

Speak up. If you are having unusual symptoms which concern you, but your physician dismisses them as “minor,” ask for a referral anyway. If needed, make another appointment to discuss. Calmly ask why your physician doesn’t feel a specialist is needed and share why you do.

Assess the relationship. Understand the relationship you have with your primary care provider. If you’re not comfortable and see signs you’re not being listened to and understood, consider finding another provider sooner rather than later. The stronger your connection, the more likely you will be heard when the time comes to be referred to a specialist."
- When Your Physician Won’t Refer: https://www.thomaswicklaw.com/blog/physician-wont-refer/