To any of you who read this blog regularly, you certainly know I’m a stalwart advocate for specialty veterinary medicine. To say the average pet parent in the United States has had little exposure to the availability of veterinary specialists for their fur babies is one of the biggest understatements in the veterinary profession. We specialists have always relied on our colleagues in primary care to refer animal owners for consultations with us. Simply stated, our patients come from family veterinarians, and without these referring doctors, we wouldn’t exist.
The times they are a-changin’
As I have written in a previous post, a non-medical person knows what a surgeon does, but the same unfortunately can’t be said for the public’s awareness of an internal medicine specialist’s skills. I don’t have the luxury of showing off a lot of fancy equipment – my fancy equipment is my brain, a tool that has been molded to approach complicated medical problems in a very unique way. During the recent recession, I heard many of my internal medicine colleagues say,
“During a recession everybody thinks they’re an internist.”
Studies have shown referrals to veterinary specialists decreased during the recession. Understandably some pet parents did not have disposable income for a referral and thus couldn’t always heed a family veterinarian’s recommendation for a consultation with a board-certified veterinary specialist. But we also know some primary care veterinarians were more reluctant (and indeed sometimes refused) to refer to a veterinary specialist for financial reasons too. In these instances, pets weren’t referred when it was in their best interest. So veterinary specialists have learned we can’t solely rely on referrals from family veterinarians to bring patients to our hospitals. We are now reaching out to pet owners to let them know board-certified veterinary specialists exist.
Now you might be reading this post so far and perceive I don’t respect my primary care colleagues. And if you think that, you could not be more wrong!
I love my family veterinary medicine partners!
Just because we as specialists are engaging animal owners in new and exciting ways to increase the visibility of veterinary specialty medicine, it does not mean we don’t value the expertise of the family veterinarian. Undoubtedly my specialist colleagues and I believe in what we affectionately call the triad of care.
What is the triad of care?
The triad of care is a concept that states a pet owner, family veterinarian and veterinary specialist should work as a team in the best interest of a pet.
Using a triangle to illustrate this model, one can see that none of the three is more important than the other; that is each is equally essential to ensure an animal receives the best possible healthcare. Family veterinarians unquestionably develop close and often personal relationships with pet parents. Primary care doctors should also embrace a partnership with veterinary specialists, as each brings different experiences, education and expertise to the proverbial table. Veterinary specialists must respect the relationship of the pet owner and family veterinarian and thus be committed to this unique partnership too. Finally pet owners must trust each doctor on their pet’s medical team, follow recommendations from each, and not play one doctor against the other.
“An ounce of prevention of prevention is worth a pound of cure”
Early detection of medical and surgical conditions is truly important for animals, especially since they can’t speak up when there is something wrong. Too many times I’ve seen a pet presented to me with a life-threatening condition that if the family had presented the pet to the family veterinarian sooner, the ailment would have been a relatively simple issue to control and treat.
Preventive healthcare with a primary care veterinarian is the most important step pet parents can take to manage their animals’ health. Many of the top risk factors leading to illness and premature death are preventable. Family veterinarians will recommend preventive care steps and goals depending on an animal’s overall health and age. When pet parents work with their primary care doctor, they are making a decision to take responsibility for their pet’s health and quality of life.
Consult with a board-certified specialist as early as possible
Not even the most proactive preventive healthcare plan can keep away all medical problems. When major health issues arise, consultation with a board-certified veterinary specialist is recommended as soon as possible. Simply stated, it is often financially beneficial to pet parents to bring a veterinary specialist onto their fur baby’s healthcare team sooner rather than later.
To illustrate this point, let me describe a classic scenario. In specialty medicine, Fridays are commonly called “dump days” – this means we receive multiple calls from primary care colleagues seeking immediate/urgent referral for patients they’ve been treating in their respective hospitals since the beginning of the week. Many times they’ve strongly recommended referral to a veterinary specialist very early, but the family declined that recommendation. Other times a referral wasn’t even considered by the primary care doctor until the last minute. A recent study conducted by the American College of Veterinary Internal Medicine documented the primary reason for referral to a board-certified veterinary internal medicine specialist was not having a specific tool or piece of equipment needed for the pet; sadly the top reason was not because the family veterinarian valued the expertise, education and experience of the board-certified specialist.
Family veterinarians perform blood, urine and imaging tests (i.e.: radiographs/x-rays, ultrasound examinations) and prescribe various therapies, but despite their efforts don’t see a meaningful improvement in their patient’s condition. So at the end of the week after spending a lot of money, either a family finally concedes to a previously recommended referral or the primary care doctor finally admits a referral is in the best interest of the patient. While a referral is always welcomed (we as specialists want to help as much as possible), all too often in these scenarios we develop appropriate diagnostic and/or therapeutic plans only to be told “we’ve already spent all our money this week”, “we should’ve listened to our vet and come to you sooner” or “I wish I had known a referral was an option.”
The take-away message about the triad of care…
Board-certified veterinary specialists embrace the triad of care, a concept that illustrates a pet owner, family veterinarian and veterinary specialist should work as a formidable team. Pet parents are strongly encouraged to follow the preventive healthcare recommendations of their pet’s primary care doctor to thwart the snowballing of minor medical problems into major ones. When a major health problem does arise, early consultation with a board-certified veterinary specialist is often in the best interest of a pet. We specialists love to work with family veterinarians to develop the most appropriate and cost effective diagnostic and treatment plans.
Wishing you wet-nosed kisses,