As a veterinarian, you're faced with an immense amount of possibilities you can encounter every single day. You have everything from the simplest puppy checkups to the most complex cases for emergency internal medicine, oncology, injuries, illnesses, and much, much more.
Chances are, you didn't train for this.
That's fine! There's no shame in not being an expert in every single realm of health for every single breed of every single species of domesticated animal that people in your area need care for.
You're not alone. There are other vets, ranging from partners in your practice, to specialists in your area, to vets who can do telemedicine, to online consultants, all of whom can help you out with anything you can't handle on your own – and anything you want a second opinion on to confirm your thoughts.
There are two ways to go about this: through informal relationships and through formalized referrals. Both of these options involve building up a network of people whose education, skills, and opinions you can trust. This referral network, whether formal, informal, or a mix, can be one of your most important assets as a vet.
The only question is, how can you build this kind of network?
Step 1: Understand Your Weaknesses
The first step to building a referral network is understanding your own place in the greater ecosystem of veterinary care local to you.
For many of you reading this, you're a primary care veterinarian for general pet health concerns, usually for the "core" pets like dogs and cats. You can provide basic care and checkups, monitoring, and certain kinds of advanced care, depending on your proclivities and interests.
There are many cases where you may end up in over your head or, potentially, just completely unable to help.
A dog comes in with osteosarcoma; you're not an oncologist, so you can't handle their treatment.
A pet owner comes in asking about care for their African Gray parrot. You don't have experience treating birds.
A cat comes in with injuries from a tussle with an outdoor animal; you don't have the surgical expertise to handle the case.
None of these are marks against you. Again, it's perfectly acceptable to have an area of expertise and plenty that you don't know. Each of those three examples will have a specialist somewhere – an oncologist, an ornithologist, a surgeon – and each of them would be unable to handle the other cases, either.
"Specialists are an extension of your primary care practice," she says. "You shouldn't think of them as your competitors. You should think of them as an arm you use to reach out and grab the ultimate prize—a stronger relationship with the pet and the pet owner." – DVM360.
Part of understanding your weaknesses is simple introspection. But, for a more formalized examination of your skills and the capabilities of your practice, you might consider a SWOT analysis.
"A SWOT Analysis is a kind of analytic examination of a business prospect. It's a framework and a way of weighing any given situation to understand the unique situation and challenges that a business might face.
SWOT is an acronym for: Strengths, Weaknesses, Opportunities, Threats.
Taken together, these four categories can give you a robust impression of the current market and area surrounding your business or project. The SWOT Analysis is a useful tool for pretty much any project, from small to large, and it's something routinely performed by large organizations before embarking on something that could be very risky, prone to failure, or very costly if something goes wrong unexpectedly."
You don't necessarily need to go through all of the hoops to perform a formalized SWOT analysis (though if you want to, the above-linked guide gives you plenty of information on how to do so), but you should at least have a solid idea of what you can and can't handle, based on the needs of patients and the services you can offer.
Step 2: Know Your Strengths
The counterpart to knowing your weaknesses is knowing your strengths.
If you're acting as a primary care veterinarian and that's all you want to do, that's fine! There's a lot of value in being a "filter" for specialists, someone who can triage patients, handle basic care, and general day-to-day services like flea treatments, antibiotic prescriptions, basic wound care, and superficial examinations. From there, your value becomes knowing what kinds of issues should be referred to which other vets and practitioners in the area or elsewhere.
At the same time, if you have greater interests and a specialty of your own – be it dental work, oncology, neurology, dermatology, exotic animals, or something else entirely – you can provide a valuable reciprocal service for other practitioners and vets in the area. You refer out what you don't know, but you do know a lot, and others can refer their clients to you when they don't know how to handle a case, and you might.
Building reciprocal partnerships is often the key to long-lasting and valuable referral networks, at least when it comes to vet networking.
All of these relationships will evolve over time, as well. People you refer to for their specialty in one area may expand to another. People who you refer to for a specialty might retire and might be replaced by someone who can't handle the same cases. Your own skills and continuing education might grow to the point where you can add another specialty to your list and take in more referrals from others.
You can also hire or partner with other vets, particularly specialists, to help you grow your own practice by bringing in more of these referrals from elsewhere. It's all about building relationships and providing the best possible care to your clients and patients as possible.
Step 3: Look for Local Resources
Finding the right specialists to reach out and partner with for a referral program isn't easy. You can't really just search for "Vets near me" and start making phone calls. Except, in a way, you kind of can. Modern technology has made it easier than ever to find local practitioners, from other GPs to narrow specialists you might not even know about. You have access to a wealth of information on Google and other search engines, as well as various veterinarian directories.
Before you reach out to a potential practice for a referral relationship, start by investigating them. Learn who they are, what they do, and, more importantly, how they're reviewed by the community. These specialists aren't springing up out of nowhere; they have their own facilities, their own client lists, and their own reputations. You want to avoid working with vets with bad reputations or who have a history of poor attitudes or a lower quality of care.
Note: Be aware that online reviews aren't always the most representative of a situation. Reviews, both positive and negative, are pretty easy to fake. You also have to take into consideration the emotional state of people leaving reviews; often, clients who are surprised with bad news and hefty prospective bills are going to be scared and angry and may lash out with "a warning to others" on the reviews, even if it's not warranted at all. That said, a big part of evaluating a potential partner practice is these reviews, not just in the content of the reviews themselves but in how the vet responds to them.
Start by looking for specialists close to you. The closer they are, the easier it is to reach out and work with them, communicate with them in person, and refer patients to them. The longer a journey a client needs to make, the less effective the referral may be, and the more extreme the need will have to be to make it worthwhile. That's not to say you shouldn't find more distant connections, just that the frequency of using those connections will likely be low, so they need to be for more extreme purposes where nothing closer is available.
Step 4: Find Online Connections
Online connections can be both easier and more difficult to set up, depending on how you're going about it.
If you're trying to essentially cold-call distant vets and set up a referral system, they aren't likely to be terribly interested without immediate need. Calling around on behalf of a patient is fine and encouraged – and you can continue the relationship after a successful referral. However, calling around for hypotheticals that might never come to fruition from a practice a hundred miles away is a tall order.
That's why the other alternative is more formalized referral systems and consulting. For example, at Hope Vet, we're a team of expert vets with specialties including oncology, neurology, dermatology, and complex internal medicine. Our goal is to provide consulting and second opinions on these various issues. It's easy to request a consult, but be aware that there's only so much we can do. We aren't likely to be able to see your patient in person, after all.
Telemedicine vets are also an option, as mentioned above. Telemedicine can be powerful for consultations and relatively simple issues outside of your specialty. However, the limitations on telemedicine, the generally low adoption of the practice for now, and the legislation making it difficult or impossible in many states or across state lines make it all a hit-or-miss option.
Step 5: Build a Standardized Referral Process
As you build relationships, work on a standardized process for referrals. You don't want to make it impersonal, but you do want to have a process for securely sending patient information and documentation to make the transition as smooth as possible for both vets and clients. This will be an iterative process and may vary depending on the software systems both you and the other vets use.
There are some tools that can potentially help with this, but every situation is unique, so it's difficult to specify any in general.
Don't Be Afraid to Drop Problematic Connections
One of the keys to a successful referral relationship is communication. Sometimes, someone has a bad day, a detail is missed, or a client becomes problematic.
After the client has been handled as best as possible, it's usually a good idea to sit down and discuss the situation with the other vet. Many issues can be resolved through simple communication.
"When a client's visit to a specialist goes well and when it goes wrong, the primary care veterinarian is, by necessity, right in the middle. Dr. Diehl says sometimes the primary care veterinarian might take the heat for something the specialist did. But if the specialist is informed, she says they can help make things right again and keep the client confident that their primary care veterinarian and the specialist have theirs and their pet's best interests at heart." – DVM360.
If a referral turns out to be difficult to work with, it's always fine to simply end the relationship. There aren't usually contracts or official programs in these relationships. If you can't work with a specialist, or you find that they don't provide the quality of care you would expect for your clients, don't make the referral.
Know When to Refer
Another key to a successful referral relationship is knowing when to refer a client. The key is to focus on providing the best possible care. Often, particularly for the general practitioner side of the equation, it can be a challenge to let go of something right at the edge of your skill level. Referring early, however, helps provide both the best quality care and the greatest amount of care. It also frees you up for more general patients.
Part of our goal as consultants in the veterinary field is to help make many of these complex decisions easier. By adding clarity and second opinions to complex situations, we can help you ensure that you're making the right decisions and providing the best possible care for your patients. It's not just for our patients, either; it's for the good of us all. More confidence, less insecurity, and a more balanced workload all help contribute to positive vet mental health as well.
If you're interested in getting started, contact us right away.