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Letter to dvm360: Practitioners, specialists should work together

September 24, 2015

Rosenbergs column damages already strained relationships.

Dr. Marc Rosenberg's August column, “Referral Interrupted: GP faces resistance from veterinary oncologist,” brings to the fore a disturbing and escalating trend that we are seeing in veterinary medicine. Reading that article, it is easy to second-guess, misinterpret and prevaricate over what occurred. The truth is that internal battles between primary care veterinarians and veterinary specialists do nothing except erode public confidence in the entire profession.

The private practitioner-specialist relationship should not be one of competition. It's imperative the two entities collaborate for the benefit of the pet and the pet owner. In Dr. Rosenberg's column, there seemed to be a turf battle going on between the primary care veterinarian hoping to provide care to a client's dog, and the board-certified oncologist who felt the need to protect his intellectual property. As a profession, we need to figure out how to cooperate to provide optimal care for companion animals. Had that happened, the patient, the client, the specialist and the generalist would have all benefited. When that becomes our norm, the veterinary profession will be stronger and more highly regarded. 

Whether a consultation takes place with an oncologist, surgeon, cardiologist or any other specialist, the ultimate goal is patient outcome. Communication, collaboration, cooperation, unity-we really need all of these right now for both the financial benefit and the future of the entire profession. 

The Veterinary Specialists Outreach and Awareness Project (VetSOAP) was started in 2013 and seeks to address concerns similar to those highlighted in Dr. Rosenberg's article. VetSOAP promotes a mutually beneficial partnership through the triad of healthcare: the pet owner, the primary care veterinarian and the specialist. We believe that when clients are educated about all the options available to them, the conversation shifts from finances to optimal care. If the opinion of the specialist in consultation with the primary care veterinarian is that the ongoing treatment should be continued with the specialist, this should be explained to the client. If the best decision is to follow up with the primary care veterinarian, then that should be explained as well. 

We all entered veterinary medicine to provide the finest care to our patients, and our options to provide this care have grown exponentially. Ultimately, the client makes the final decision, but with a trusting and committed partnership between the specialist and the primary care veterinarian, we can truly provide the best options for that pet. 

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Dr. Rosenberg's article highlights an unfortunate interaction that demonstrated a missed opportunity for communication and cooperation between a veterinary specialist and general practitioner. Open, clear and honest communication is the best tool we have to prevent misunderstanding and conflict between individuals and groups including veterinary specialists and primary care practitioners. These two groups are often at perceived cross-purposes. However, our belief is that this perception is not based on fact but is actually more of differing perspectives. 

Julie D. Smith, DVM, DACVS, CCRT, MBA

Board of Directors, Veterinary Specialists Outreach and Awareness Project


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