Cat - Second Opinions and Referrals

What is the difference between a second opinion and a referral?

Not long ago the terms were synonymous (meant the same thing). The expression 'referred for a second opinion' was commonplace. The vet who undertook this was often a general practitioner sometimes in the same practice or one not too far away who happened to have a special interest in, or experience with a particular condition or sometimes the type of pet, e.g. long haired cats, giant breeds of dogs, orthopaedics, intestinal conditions etc.

With the growth of post graduation specialisation and the acquisition of the Royal College of Veterinary Surgeons (RCVS) certificates and diplomas in a range of subjects, from dermatology to ophthalmology, small animal orthopaedics, diagnostic imaging, specialists similar to consultants in human medicine have emerged and are recognised by the Royal College of Veterinary Surgeons.

There are currently less than 150 recognised RCVS specialists (including feline), although there are many more veterinary surgeons with certificates and diplomas, indicating their specialised knowledge and interest in their chosen subjects. This has led to a subtle difference in the meaning of referral and second opinion and specialist, certificate holder and diploma holder.

Today a second opinion is still basically what it says. It can be suggested in the first instance by the veterinary surgeon who feels that two heads are better than one, and indicates that he would welcome another opinion on the case. These are sometimes carried out by another veterinary surgeon in the same practice.

Referral often means a second opinion from a veterinary surgeon who is a recognised RCVS certificate or diploma holder or a specialist in that particular field. It is often suggested initially by the first opinion veterinary surgeon, i.e. the practice treating the animal. Today as owners become aware of the availability of specialist veterinary services many owners are requesting referral. However it is important to remember that this should be discussed with the veterinary surgeon treating the pet in the first instance.

What are the reasons for referral?

Pets can be referred to a specialist opinion for a variety of reasons. They fall into two main groups:

1. Sometimes this is very simply because specialised diagnostic or therapeutic equipment is required for diagnosis or specialised treatment.
2. To seek more expert knowledge either in respect of the particular species, e.g. dog, cat, rabbit etc, or because more specialised knowledge is required regarding the disease or condition, e.g., orthopaedic specialist, soft tissue specialist, etc.

Sometimes a referral will be made in order that specialised diagnostic techniques can be carried out, e.g. to a diagnostic imaging specialist for MRI.

What do I do to arrange a referral or second opinion?

We, your veterinary practice and you, the owner, have one thing in common, the welfare of your pet under our care. If you feel you would like a second opinion or a referral please feel free to discuss it with us and then together we can decide what is best for your animal. It is important at the outset that the specialist or second opinion vet has all the facts so once you have discussed this with us, we will endeavour to make the appointment for you and ensure the full case history including any laboratory or diagnostic records are forwarded in time for your appointment.

Just like the medical profession, most referral practices prefer to make appointments through the first opinion practice. In this way they can discuss the problems with the referring veterinary surgeon as necessary.

What about cost?

Referral to a specialist or a certificate/diploma holder is obviously considerably more expensive than a first opinion consultation. If your pet is insured the cost is usually covered by the insurance company but it is imperative that you establish this with your pet health insurer beforehand.

Most referral centres will try to give you an approximate estimate of likely costs involved. We are happy to obtain this information for you at the time of making the appointment, however it must be stressed that this can only be an approximate estimate of costs and not a quotation.

Is referral likely to involve considerable travelling?

This depends entirely upon the type of specialist opinion required. Referral to an RCVS recognised specialist may involve a visit to a veterinary school and sometimes travelling a considerable distance. Today more and more referral centres are being established. These often have a variety of specialistsor certificate/diploma holders working under one roof. Please feel free to discuss this with us and we will do our best to help.