Medical system fail

I went in to see a doctor two weeks ago for a weird growth under the skin near my elbow. The general practitioner said, "It seems like you might have hit your elbow on something and chipped off a small bone fragment. Your body is building something around it. I could probably remove it, but I'd feel better if you had a dermatologist take care of it." He walked me down the hall to a dermatologist's office, all the while asking me about behind-the-scenes stuff in Whale Wars (he was a fan, and saw a Sea Shepherd patch on the vest I was wearing). After an hour of waiting around, a dermatologist finally saw me, examined my elbow, and said, "Yeah... that's near a joint. I'm going to refer you to an orthopedic surgeon." 3 minutes of face time. Done. I just got a bill for $225 from the dermatologist's office. Haven't received a bill yet from the GP, but I expect to get one any day. Why didn't the GP refer me directly to an orthopedic surgeon? I think I just got scammed.