Meeting the expectations of referring veterinarians.

Veterinary teaching hospitals (VTHs) have traditionally obtained most of their patient and client base through the referral process. This worked well until the recent explosive growth of specialty practices, which compete not only for patients but also for faculty and graduating residents. Veterinary schools have had to meet this challenge by increasing both efficiency and the quality of services provided to referring veterinarians. Practitioners refer mainly because of discomfort with a case and the belief that clients will get better treatment at a referral hospital than they themselves can provide. Practitioners choose not to refer because of geography, perceived cost, or lack of confidence in the services offered. Referring veterinarians expect regular communication about services offered, access to receiving clinicians for consultation, convenient scheduling, and efficient communication and follow-up from the receiving veterinarian. They also expect the relationship between them and their clients to be maintained and enhanced. Receiving veterinarians expect a summary letter and copies of all relevant records, including radiographs. They also expect the client to have been informed about the approximate costs of referral. VTHs can develop better relationships with referring veterinarians through education, newsletters, referral guides, practice visits, and Web sites. Inadequate communication and lack of involvement on the part of the referring veterinarian are the major impediments to efficient referrals and practice growth.