You are correct that this is a stupid system. So your DH goes, gets evaluated and they decide Dr. X is the best person for his situation. But the insurance dictates whether they pay this doctor. Or you can go with Dr. Z who may not be as good, but is in network.
My son had such a runaround trying to get an HMO referral for a sleep doctor, he had to cancel 2 appointments due to paperwork. The office would not even let us just pay out of pocket for the appointment!