Making a referral and working with specialists
Practitioners who refer an oncology patient to a specialist should be mindful of the following considerations:
- Each patient and case is unique.
- Referral of an oncology patient is a multifactorial process that considers the patient’s quality of life (pre- and postreferral) and the pet owner’s preferences, emotional attachment to the animal, and the adequacy of his or her physical and financial resources to properly care for the animal.
- The primary care clinician, specialist, and pet owner must work together as a unified healthcare team and have a shared understanding of the options, procedures, and expectations of referral treatment.
- Aside from maximizing the patient’s survival, all parties involved in referral decisions should focus on the patient’s quality of life and the importance of providing compassionate, empathetic support for the owner.
Referral of an oncology patient may be appropriate for a variety of reasons. These include when the primary care veterinarian or the client wishes to consider all possible treatment options or when the referring veterinarian cannot provide optimum treatment for any reason. In addition, specialty referral practices often have access to clinical trials in which the client may want to participate.
Referral to a specialist should be case-specific. Referrals are appropriate when the primary care clinician can no longer meet the needs and expectations of the patient and client. The comfort level of the primary clinician and client with referral treatment will dictate how early in the process case transfer should occur. The importance of a clear, shared understanding of the referral process by the pet owner, primary care veterinarian, and specific referral specialists or referral centers cannot be overemphasized.
Determination of the preferred method of collaboration and case transfer between the primary care clinician and specialist should be made in advance of the referral treatment. It is also important to recognize that a variety of specialists may be needed at varying time points in the patient’s referral treatment process. After referral, it is important to establish a treatment plan for ongoing communication and continuity of care between the primary care clinician, the specialist, and the owner.