How to know if you need to see a specialist
It’s not an enviable position to be in but it happens at least a couple times a day at my hospital. That’s when owners realize their pets are in more trouble than they’d thought. Hearing the veterinarian proclaim the need to see a specialist seals the deal. Things are bad––or at the very least, it’s clear they’re going to get expensive.
So you know, veterinarians now come in many flavors. Bland vanilla is mine––I’m a “general practitioner.” But a growing percentage of my colleagues are branching out into fancy flavored specialties like internal medicine, cardiology, surgery, ophthalmology, neurology, critical care, radiology and dermatology––to name but a few. They study three to five years more than the average veterinarian––which means they know oh-so-much-more about their area of expertise, but which also means they charge higher prices.
So when a patient with a nasty fracture walks in the door, I can offer pain relief, take X-rays and, should the break look like it needs surgery, send my patient to my friendly neighborhood specialty practice––which is where the surgeons live.
Or when I hear a murmur in a young puppy I can call over to my cardiologist and have him come over with his fancy equipment so she can assess the extent of the problem––something I’d otherwise be unable to do considering the expense of the equipment and my inability to be all things to all patients.
For me, the generalist, that means I can concentrate more heavily on preventive medicine and work on more assiduous screening of my patients for medical concerns that might otherwise go unnoticed. It means that I can help my patients access a higher level of care––if they can afford it. If I pay attention, I can also learn a great deal from my interactions with specialists, thereby offering my can’t-go-to-the-specialist-‘cause-it-costs-too-much clients a better alternative than they’d previously had from a generalist.
Of course, that also means that a lot of my “fun” cases walk out the door with their interesting injuries and curious diseases––not to mention their dollars. But it’s a trade-off that leads to better medicine and better outcomes all around. And ultimately, that’s what everyone wants.
But how exactly do you know when you need to see a specialist?
The answer depends on lots of things. How close is the nearest specialty hospital? How high is the standard of care in your area? Is your veterinarian’s philosophy an “I-can-do-it-all,” “I’d-like-to-save-my-clients-money” approach?...or is it one where more help is always welcomed and valued?...regardless of the price.
Sometimes it’s best to stay with your general practitioner––as when your funds are seriously limited and you have no choice. Or when you trust your veterinarian implicitly and worry that seeing another vet isn’t going to be your cup of tea.
But mostly, seeing specialists in veterinary medicine should be much like seeing specialists in human medicine. If you’ve got a significant heart problem you should see a cardiologist. If you’ve got a non-routine eye problem you should see an ophthalmologist. Etcetera.
But how do you really know whether your general practitioner veterinarian is steering you right, given your basic philosophy? Should you ask for a referral to a specialist? Will your veterinarian be offended if you do?
The answer on this one isn’t easy. Nonetheless, I have a rule of thumb I offer my friends and family: Do some research on your pet’s condition. Check out what other pet owners are doing for pets with similar problems. If it happens that the majority of the similarly-afflicted pets out there are under the care of a specialist...then perhaps your pet should be, too.
Oh, and don't forget to email me ([email protected]) the topics you’d most like to hear about––medical, money, ethical or otherwise––and prepare yourself for my opinionated answers.
Dr. Patty Khuly