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Special Report: AAEP Convention Business Coverage

By Amy Grice, VMD, MBA

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Improving Referral Communications

Communication is key in referral situations and when working as a relief practitioner for another vet.

When veteri-narians refer their patients to specialists or referral centers, mis-

understandings and miscommunica-tion are common, according to Colleen

Best, DVM. � ese troubles lead to less satisfaction with the referral experience on both sides. Because of the impor-tance of the referring DVM to the ongo-ing health of the horse and the success of the referral center, special attention needs to be paid to the relationship be-tween the referring DVM and special-

Special attention needs to be paid to the

relationship between the referring vet and

the specialists to which they refer.

ists to which they refer, said Best. A study at the Michigan State Uni-

versity Large Animal Teaching Hospital revealed that referring DVMs frequently experienced di� culties with schedul-ing, communication and perception of respect for their abilities. Best reported that, “Timely and frequent communica-tion between the referring DVM and the specialist facilitate collaboration and contribute to the formation of a respectful and trusting relationship.” She suggested that using clinical com-munication skills is the most e� ective way to improve.

Communication skills that are needed include open-ended inquiry, at-tentive listening, empathy, contracting and safety netting, said Best.

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Open-ended inquiries are questions that cannot be answered with “yes” or “no.” Because they produce a longer, more detailed answer, there is more op-portunity for demonstration of respect of the other’s opinion and the gain of complete case information.

Attentive listening can create an atmosphere of trust through appropri-ate pauses, rephrasing of responses and non-verbal cues such as an unhurried pace and calm tone.

Empathy demonstrates an under-standing of the experience/situation of the other that is clearly communicated.

Conracting will occur when you de-termine what roles each party will play in the referral; a thorough understand-ing of expectations greatly increases satisfaction with the referral process.

Safety netting is a discussion ahead of time of what will occur under unfore-seen circumstances.

Best reminded the audience that when meeting resistance in the com-munication between the referring DVM and specialist, it is important to seek an area of similarity to encourage team-work. In conclusion, she said, “� e re-lationship between the referring doctor and the specialist impacts the quality of care provided to the patient, as well as the experience of the client.”

How to Be a Relief Veterinarian

Tricia Arnold, DVM, called upon her experiences as a relief veterinarian to o� er a blueprint for working in this sector of the veterinary industry. She made a strong case for relief services by pointing out the struggles of solo prac-titioners in � nding a balanced lifestyle. In urban centers, she said, there is gen-erally a large pool of companion animal relief veterinarians, but few o� er large animal services. Whether for vacations, recovery from injuries, maternity leaves or attendance at continuing education events, equine veterinarians have a need for relief services.

To establish yourself as a relief veteri-narian, Arnold suggested sending letters to practices that might need relief; invit-ing colleagues for co� ee to discuss relief needs; riding along with a colleague to get to know them better; attending horse events and introducing yourself to the vet on call; and providing references.

Being � exible about methods of work-ing is important, said Arnold. She has an incorporated business, so she can work as a sub-contractor, or if there is ongoing regular relief work, she might work as an employee of that practice.

She suggested being open to using a practice vehicle and gas card, or using

your own vehicle with mileage reim-bursed at the IRS-established rate and all drugs at cost. In her relief practice, Arnold uses the diagnostic equipment owned by the practices she serves.

Compensation for relief services var-ies, said Arnold. Among those compen-sation methods she has accepted are: a guaranteed daily base pay plus emer-gency fees; a guaranteed daily base or 50% of professional service fees per day, whichever is greater, plus emergency fees; a daily service fee of 2x the base, but no emergency fees; and a guaranteed base pay for the length of the engagement or 37.5% of gross revenue earned, whichever is greater, but no emergency fees.

Arnold charges a variable base fee de-pendent on the cost of the commute, the availability of revenue-producing work, and the need to stay overnight.

Arnoldescribed the advantages of relief work, but she said there are chal-lenges that require open, honest com-munication. � ese include: failure to be paid in a timely manner for services; accommodating di� erent practice styles while maintaining a high standard of care; recordkeeping requirements to allow appropriate follow-up and legal protection; and concern of client or case poaching. Most important, she said, is to establish yourself as a trusted resource for other veterinarians, rather than a competitor.

The relationship between the reffering doctor and the specialist impacts the quality

of care provided to the paitent, as well as the experience of the client.

Relief veterinarians need to establish

themselves as trusted resources.