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I’ve always said a good veterinarian is one who listens. Not only to “Dr. Mom” or “Dr. Dad” but also to veterinary technicians and to other veterinarians in the same practice. A great veterinarian does all that and more: He reaches out for the help of specialists when a situation calls for it. Sometimes that happens without your even being aware of it.
With the ease of email and online services (and even the old-fashioned phone call or face to face at a veterinary conference), we veterinarians can pick the brains of top specialists, professors and researchers pretty easily, which helps us keep up on new treatments and strategies. But we are also likely to refer our patients to specialists when we think it can help.
Like any doctor, vets refer patients to specialists for specific health issues. It’s pretty typical for veterinarians to suggest referrals to veterinary oncologists after a diagnosis of cancer, for example, or to cardiologists for the management of heart disease. But though we frequently refer because we know what something is, we also send patients on to specialists because we don’t know what we’re dealing with. Sometimes we refer because we have tried everything we know to do and it’s not working. And sometimes, specialists are called upon for difficult procedures we’re rarely faced with or don’t have the high-tech equipment to do.
But a specialist referral isn't just for illness or injury. As we understand more how medication can help with common behavior problems, we veterinarians are also referring to veterinary behaviorist colleagues. While some wags may mock these specialists as “pet shrinks,” I know they’ve saved many pet owners’ sanity and many pets’ lives.
So what would prevent your veterinarian from suggesting a referral? There are a few reasons, and they’re all worth discussing with your veterinarian if you feel your pet’s care isn’t getting anywhere and he hasn’t brought up a referral on his own.
Sometimes it has to do with where you live. Many urban areas support independent specialists or specialty group practices. But in less-populated areas, unless you live near a school or college of veterinary medicine, specialists can be hard to find. For some people, these travel issues are insurmountable. Your veterinarian knows this and may be hesitant to suggest a specialist as a result.
Cost is another issue, especially these days. Many veterinarians find their recommendations turned down so often for money reasons that they stop offering care options like specialists. When I talk to colleagues at conferences, by the way, I strongly disagree with that approach. It’s my job to offer all my professional recommendations without regard to cost. Once it’s all on the table, then and only then can I base a course of treatment on what someone can afford and when. But I am first and foremost an advocate for a pet’s health, and I can’t be that if I don't inform a pet owner of everything that could and should be considered in terms of treatment for a pet's health issues.
It’s your veterinarian’s responsibility to offer all the care options for your pet, and it is your responsibility to speak up if you think you need more than you’re getting. That means if you feel you need a referral (or a second opinion), you have to be the one to ask.
Whether you ask or your veterinarian offers, your veterinarian should work to coordinate specialty care. Specialists typically are brought on board to address only one thing. They don’t handle routine care and will send you back to your own veterinarian for all other matters or when a situation is finally resolved. The mutual respect and cooperation between referring veterinarian and specialist is key to the smooth and effective handling of your pet’s care, so it’s important you understand how it works.
We’re all in this together for the care of the animals we love. The use of top-notch specialists is good medicine, and that means healthier pets.
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