Sharing limitations

I read with interest Dr. Barry Kipperman's article, "Specialists and general practitioners share limitations." How very true that is! This seems to be a hot topic because your April issue had two articles about specialists versus general practitioners.

I have been contacted to address this issue at the Oklahoma state meeting in January 2005. Dr. Kipperman had many valuable points. It would seem that ego is a driving force for both groups.

Ego is not bad, but it should not get in the way of our mission-the best compassionate care for the animal. Fortunately, I have been in general practice and now a surgery referral practice. This gives me good insight into both sides of the issue. It is hard for young specialists who come up the ranks of veterinary school, internship, then residency, to understand the reasons all cases referred to them have not had an extensive work-up. They should walk a mile in the general practitioners' moccasins!

Most of this boils down to communication. It is imperative that specialists view practitioners as part of the team and communicate with them frequently. They should always keep the family veterinarian in the loop as to decision-making. After all, it is the family veterinarian who has the long-standing relationship with the client and pet, not the specialist.

The rapid expansion of specialists in private practice is changing the way all veterinarians must view the referral cases. Each veterinarian is held to the highest standard of care in their area.

I agree with Dr. Kipperman in that if you are practicing 100 miles from the nearest specialists, your standard of care may be different than if specialists are available nearby. The bottom line should always be what is best for the patient, not what is best for the client. It is incumbent on the veterinarian to make recommendations for the best care possible (often including referring the case), and not make the decision for the client. This is especially true when it comes to finances. Yes, specialists are more expensive, but the client should decide for themselves rather than the general practitioner making that decision for them.

All specialists should make sure the referring veterinarian is kept informed and not speak negatively of how a case has been handled. No case should ever fall in the "black hole," as I have heard many general practitioners describe after referring a case to a university.

This will be an ongoing issue, and it should be discussed at all levels. Ideally, the topic will be incorporated into all of the specialists' annual meetings.

As a prominent individual once said, "Why can't we all just get along?"

A.D. Elkins, DVM, MS, Dipl. ACVS, Veterinary Specialty Center of Indiana, Indianapolis, Ind.