All about referrals: advice to clients
Everyone is familiar with the traditional figure of the veterinary surgeon treating all kinds of animals and he is expected to be expert in everything from kidney disease in kittens to colic surgery on a carthorse. However, faced with an ever-increasing fund of veterinary knowledge, it has become impossible for any individual vet to remain up-to-date and expert at everything. In order to anticipate and meet the needs of patients and clients, the UK veterinary profession has evolved a system of 'veterinary referral'. By considering a referral of your animal to a colleague, your vet is ensuring that the patient can benefit from the best of diagnosis and treatment that the profession has to offer.
To maintain consistency and ensure predictable high standards the Royal College of Veterinary Surgeons (the veterinary profession's governing body) oversees a system of clinical training, further examinations and Specialist recognition.
Why refer?
Some cases are referred for diagnostic tests or treatments which are not available at your own practice. This enables efficient use of expensive complex equipment and allows the patient to be seen by a veterinary surgeon with particular interest, experience and expertise in that type of case. This is a well known procedure in human medicine where family doctors regularly refer, for example, heart cases to expert cardiologists, skin problems to dermatologists and so on.
Which cases need to be referred?
Whether or not a case is referred is agreed by discussion between the client and his usual veterinary surgeon. There is still considerable overlap between the work done by a referral practice and by your local practice. Your own veterinary surgeon will give you all the information you need to decide whether or not you want a referral Whilst a 'Specialist' might reasonably be expected to perform, for instance, a surgical procedure more expertly and with a better prospect of success, the higher fee and the need to travel to a distant referral centre may bee seen as a disadvantage. Your own veterinary surgeon has a responsibility to provide you with all the information needed to make a proper and fully informed decision about referral.
What will it cost?
Referral services do tend to be more costly than other veterinary work. This largely because the cases treated are usually more complex and time consuming, often requiring the use of expensive equipment. Additionally, the extra time and cost of acquiring specialised clinical training and qualifications is reflected in the fees charged by most referral centres. All veterinary surgeons, including referral clinicians, are happy to discuss costs and provide an estimate of the fees involved before any treatment is commenced.
Where will my animal be sent?
Formerly the clinical departments of the six UK university veterinary schools and the Animal Health Trust in Newmarket provided most of the referral services in the United Kingdom. However, in recent years an increasing number of RCVS Diplomates and Specialists are working in private practice across the country. Whilst any veterinary surgeon is free to accept referral cases most practices choose to refer where possible to colleagues who are Diplomates of the RCVS, or are RCVS Recognised Specialists in the knowledge that these colleagues are trained and qualified to an appropriate standard.
How is a referral arranged?
Your own veterinary surgeon will contact the referral centre to arrange an appointment and communicate any relevant case note and other clinical information. Afterwards your animal will be returned, as quickly as possible, to the care of your own veterinary surgeon.
The referral centre will provide your own practice with a report of the patient's treatment and any necessary information and instructions relating to ongoing care.
If I have a complaint?
When referral works well, everyone benefits, the patient, the owner and both veterinary practices. However, on rare occasions problems may arise, leaving the client dissatisfied. Most often this down to misunderstanding and is best resolved by talking it over with either your own veterinary surgeon or the referral practice. If this does not resolve the matter and you consider it to be sufficiently serious you may make a complaint to the Royal College of Veterinary Surgeons which is responsible for regulating the conduct of all veterinary surgeons, including those in referral practices.
List of Recognised Specialities
The Royal College of Veterinary Surgeons maintains a list of recognised specialists in a large number of specialities including:
Veterinary:
Anaesthesia
Cardiology
Dentistry
Dermatology
Epidemiology
Neurology
Nutrition
Ophthalmology
Diagnostic Pathology
Public Health
Radiology
Reproduction
Small Animal Medicine
Small Animal Surgery
Equine Internal Medicine
Equine Surgery
Equine Stud Medicine
Exotic Animal Medicine
Zoo & Wildlife Medicine
Deer Health & Production
Fish Health & Production
Goat Heath & Production
Poultry Health & Production
Sheep Health & Production
Pig Medicine
What do the qualifications mean?
All veterinary surgeons have a string of letters after their name, which are sometimes difficult to understand. Here we try to explain the relevance of the various clinical qualifications which practising veterinary surgeons might achieve:
MRCVS
Membership of the Royal College of Veterinary Surgeons. This is the entry qualification without which no one is permitted to practise veterinary in the United Kingdom. It is awarded after five years' successful study at an approved university veterinary school.
Certificate Level — Cert CHP, CertVD, Cert SAS etc.
A certificate is an indication of a competent clinician and is obtained by examination not less than 2 years after qualification as a veterinary surgeon.
Diploma Level: DBR, DDVA, DLAS etc.
A diploma is an indication a high standard of academic and professional expertise gained by examination.
Specialist Recognition
Recognition as a specialist by the RCVS is an indication of an expert who usually after obtaining a diploma, has satisfied a number of other stringent criteria. Uniquely specialist status is reviewed and re-assessed every five years. These clinicians are identified by the title 'RCVS recognised specialist in'
Whilst the majority of referrals will be made to clinicians with a diploma or specialist recognition, there are occasions when other, less formally qualified, will accept referral cases. Your veterinary surgeon will be happy to answer any questions which you may have.
This advice should be considered in relation to the following sections of the Guide to Professional Conduct:
- Part 1 F: Your Responsibilities to Your Professional Colleagues
- Part 2 D: Referrals and Second Opinions
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