More and more vets are electing to spend an extra four years (or more) to become board-certified specialists in a variety of fields within veterinary medicine. In small animal medicine vets can become board-certified as surgeons, internists, dermatologists, dentists, ophthalmologists, behaviorists, cardiologists, oncologists, neurologists, and radiologists.

With all these specialty services available an educated owner looking for the best healthcare possible needs to ask: What do these services mean for my pet and me? How do I know if my pet needs to see a specialist? How do I find a good one?

As in human medicine, the answer lies in hiring a good generalist before making the leap to a superstar specialist. This is the hard part, usually. The generalist (AKA, the regular vet) is the chief. He or she maintains a healthy relationship with you and your pet and refers the two of you to a specialist whenever appropriate.

A good generalist will use veterinary specialists judiciously and often, preferring to offer your pet the highest quality medicine you can afford rather than attempt procedures and protocols best handled by the pros.

Generalists have their set of basic tools to perform them with. If they accomplish their job well they will often find problematic issues that will lead to the use of more complex tools, which will sometimes elucidate the need for even more complex tools. At some point these tools become rarely used implements much better wielded by those for whom these tools are commonplace. That’s when the specialist comes into play.

So here’s where the waters get murky: it’s not always clear which tools are standard fare for generalists and which are not. Specialists are very new to veterinary medicine, a rapidly growing phenomenon of the last ten to twenty years. Clear standards have not yet emerged to help vets (much less their clients) negotiate this sudden shift.

Which tools are ours? Which are theirs? It’s a quandary that has created huge rifts in veterinary medicine.

Consider: Some generalists feel perfectly comfortable with fancy tools, even if they don’t get to use them very often. Other generalists (older practitioners, typically) have never had to rely on anyone to use fancy tools in their stead. Neither wants to give up their fancy tools (never mind the satisfaction and income that comes with them).

To make matters worse, some generalists just don’t want anyone else looking over their shoulders. As a profession, veterinary medicine has historically been comprised of highly individualistic people. We’ve enjoyed practicing in isolation. But the times are indeed changing. With higher standards of care, better medicine usually means more than one vet in a hospital, the ability to ask questions of other vets, and the willingness to refer cases to vets who know more than you do. This is basic but, unfortunately, not yet commonplace.

Three major issues predominate as you consider the appropriate use of specialists for your pet’s care. I call them the ABCs of generalist-specialist interaction. Understanding them will help you get better care for your pet.

Availability: Specialists are only available by referral from your veterinary generalist (vets like me). You can’t just walk into the specialist’s hospital when you want your pet spayed by a veterinary surgeon. A referral is necessary to maintain the relationship between the generalist and the specialist for two reasons: 1-Your regular vet is the chief of your pet’s overall care. He or she knows your pet’s underlying health conditions, drug sensitivities, and other pertinent issues. 2-Most generalists would see an independent action by a specialist as stealing you, their client. This so-called stealing is a big no-no for specialists.

aBility: To be sure, specialists have skills we don’t. But consider the simple spay: Generalists do multiple spays every week. Specialists do a few a year, usually when pathologies like uterine infections or cancers are present. Surgeons and other specialists are best employed when they’re likely to do a better job. Generalists have the proficiency in some procedures that comes with having more experience performing them.

Cost: Specialists are more expensive for a variety of reasons: they have larger staffs, more sophisticated equipment, and a larger knowledge base for a narrower set of tools. You pay for this additional training so use it only when you need it to conserve your resources for the long haul.

I hope this information helps you both improve your relationship with your generalist and your specialist should your pet ever need one.