How do specialty practices define who their clients are? What are the key factors in keeping them happy?

"It's a dual client base," says Dr. Karen Felsted, CVPM, CPA, a consultant with Gatto McFerson in Santa Monica, Calif. "One set is obviously pet owners. The second set is made up of referring veterinarians. To the extent that most specialty practices get most of their business from referrals, it's just as important to keep the referring veterinarians happy as it is the pet-owning clients."

Maintaining a mutually respectful and communication-based relationship with a referring practice helps make sure a large portion of your business isn't taken elsewhere. Dr. Felsted says specialty practices must make an extra effort to keep good ties with their referring counterparts, who exist off-site, unlike the pet-owning client who stands literally in the reception area or exam room. To keep the lines of communication open, update the referring practice on the patient's progress early and often, she says.

If things happen to go badly with the referring practice or communication has been poor, you'll have to handle the situation with kid gloves. "Referral practices have to be treated with careful consideration and professionalism," Dr. Felsted says. "If you upset a pet-owning client, you might lose that client, which we absolutely don't want. But the magnitude of upsetting a referring veterinarian is far greater because then you've lost multiple referrals and pet owners. If the referring veterinarian is in a multi-doctor practice, you may lose the whole practice as a referral base."