Estonia has a free state health system, but also has a limited number of health specialists. This means that there are long waiting lists for appointments. You might even have to wait a few months to actually see the doctor. In order to prevent a situation where people go and see health specialists with minor problems, a referral letter (from your family doctor) is required to book time with a specialist. This way, those who are really in need won't be left on an even-longer waiting list. For example, maybe that itchy skin really isn't a concerning skin allergy, but instead just a nasty Estonian mosquito bite that will shortly heal itself. Your initial instinct might be to try and see a dermatologist as quickly as possible, but by starting with a family doctor, he or she will be able to identify minor issues, and alleviate any major-risk concerns. In situations where the patient does have a serious issue, though, a family doctor will always know the proper professional to recommend.
It's worth noting, however, that a dermatologist is one of the health specialists you can see without a referral letter. Similarly, you can visit a dentist, gynecologist, sexual health specialist, psychiatrist, and ophthalmologist, all without a referral.
Read more about specialized medical care here: https://haigekassa.ee/en/people/health-care-services/specialised-medica…