I don’t know any veterinary clients, including myself, who want to hear that their pet needs a referral to a specialty hospital for further care. The primary veterinarian’s recommendation might create immediate anxiety about the medical condition’s severity and apprehension about the costs. During such conversations, be prepared to answer questions and guide your clients while recognizing that every situation is unique. The goal is to help pet owners decide what’s best for the animal and its family.
Let’s look at issues that inevitably arise when you speak with clients about specialty care and how to navigate the conversations confidently.
Responding to Concerns
When primary care veterinarians initiate dialogue about a possible referral to a specialist, pet owners often display various emotions, including frustration, fear and sadness, especially if the news is unexpected. Seeing a specialist can heighten concerns about the pet’s prognosis and longevity. Clients also understandably feel frustrated going to another hospital to see a doctor they don’t know and trust. They might ask, “Why can’t you do it here? Aren’t you a licensed veterinarian?” or “Can’t you just treat the problem another way?” They might even question your expertise by asking, “Should I go somewhere else for a second opinion?”
When clients aren’t familiar with specialty care or have reservations about seeing another doctor, you should share how you built a strong relationship with specialty centers you trust.
Promote the Triad of Care
A good idea is to explain that the triad of care is a collaborative partnership between the pet owner, primary care veterinarian and specialist and that everyone will work together to ensure quality patient care. Let clients know that the benefits of collaboration include access to advanced diagnostics and treatments as an extension of your practice. Clients will appreciate knowing that you routinely work with specialists to support a complete range of care options.
Communicate the Referral’s Value
Sometimes, clients doubt the need for a specialist. They might ask, “Why do I need to go there for Jake to have surgery?” Likewise, they might question the value of specialty care with comments such as, “Chemotherapy seems crazy. Maybe we just need to let her go.”
It’s not unusual for a client to have misconceptions about specialty treatment options and the associated prognoses. For example, a pet owner might not know that animals tend to tolerate chemotherapy better than people and that, in many instances, the drugs are more affordable and can extend lifespans by a year or more.
I’ve heard veterinarians briefly mention patient referrals with a statement such as, “You could see a cardiologist.” Rather than conveying a clear treatment option, that message suggests that specialty care isn’t necessary, and it might reinforce the idea that a referral is too expensive.
A referral’s genuine value lies in the specialist’s expertise. Primary care veterinarians can reinforce that perspective by communicating that they are referring the pet for a consultation, not just sending it somewhere else for a procedure.
Here are examples of how to communicate the value of a referral:
- Don’t say: “Murphy needs to go to the specialty hospital for a cruciate surgery.”
- Do say: “I’d like to refer Murphy to an orthopedic surgeon for a consultation and to provide a definitive diagnosis. The surgeon will use the findings to recommend a treatment and review your options. We can then work together to determine what’s best for Murphy and your family.”
- Don’t say: “I recommend you see an internal medicine specialist for an ultrasound.”
- Do say: “Let me share with you the benefits of having Sophie seen by a board-certified internist for a consultation. The value of going to a specialty center is to confirm her diagnosis and learn about the best treatment plan. This strategy can help prevent the progression of the disease, hopefully leading to increased longevity and giving you peace of mind that you know all the care options.
After outlining the benefits of a specialty referral, ask an open-ended question such as, “What are your thoughts about going to a specialist?” or “How are you feeling about what we discussed so far?” This approach helps clients feel heard and allows them to express emotions or ask for more information.
During such conversations, you must convey empathy and understanding. You might say:
- “I can see you’re worried, and I’m so sorry to give you this news about Ginger’s heart disease. We’re here to support you.”
- “I know this is not the news you wanted to hear. Thinking about Murphy having surgery and the postoperative care can be scary. We routinely work with Dr. Walsh, who is an excellent, compassionate surgeon.”
- “I know this is a difficult time. Rest assured, we will keep in touch with you and the specialty hospital.”
The Money Issue
Specialty care can be expensive, so concerns about the cost are at the top of most pet owners’ minds. Typical thoughts include, “I can’t afford it” and “This will cost me a lot more money.” Don’t assume a client isn’t willing to pay for specialty care. Regardless of their budgets, clients appreciate talking about a referral because they recognize you are laying out all the options.
Here is how to help pet owners decide whether to see a specialist.
- Don’t quote fees unless you know the cost.
- Let them know a referral might offer peace of mind. Recommend that they focus first on the consultation and assure them the specialist will explain the cost of various treatment options.
- Say many specialty practices offer financing plans that align needed care with budgets.
- Focus on the benefits of seeing a specialist and how specialty care may improve the pet’s life.
While a referral recommendation doesn’t always result in a patient visit, my advice can help clients appreciate specialty care’s benefits and help pets get the care they deserve.
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The 2025 ACVIM Forum, an annual conference hosted by the American College of Veterinary Internal Medicine, takes place June 19 to 21 in Louisville, Kentucky. Learn more at bit.ly/4gLNtun.