Make friends when you make referrals

It was a quieter world when Dr. Jay Merriam started his career as an equine practitioner. It wasn't due to fewer cars on the road or fewer people—it was the doctors who were quiet. When Dr. Merriam came to town years ago, some of the older equine veterinarians didn't communicate much about cases—especially referred ones. He wouldn't hear a peep if one of his clients went to another doctor for a second opinion. Fear of competition seemed to lead to a loose-lips-sink-ships—err, practices—philosophy. Dr. Merriam, now owner of Massachusetts Equine Clinic in Uxbridge, Mass., threw that philosophy overboard a long time ago. He knows firsthand the medical and financial benefits of referring to other veterinarians, and vice versa.

Do you hesitate to refer patients to other veterinarians with haul-in facilities, specialized knowledge, or diagnostic equipment? Don't worry—you too can build relationships with colleagues and make sure no one poaches your clients. Everyone wins in a community with good communication and good referral policies.

WHY REFERRALS WON'T HURT YOU

Maybe you're a bit scared. One doctor across town has a haul-in facility. Another doctor spent a lot of money on new, high-tech equipment. A third doctor is available more often and covers more emergencies. Take a deep breath and consider this: Clients choose their favorite veterinarian for a number of reasons, and a haul-in facility or an MRI machine aren't necessarily at the top of the list.

Dr. Dina Duplantis, owner of Equine Health Maintenance, an ambulatory practice in Bueche, La., regularly refers clients to the local university's ambulatory service to take digital radiographs for her clients. Results from cases she refers to the university for diagnostics, especially, come right back to her when decisions need to be made. "Clients trust us. They want our opinion," Dr. Duplantis says. "The referral clinic or school is doing the procedure or the diagnostic, but the client still consults with us."

For one, clients without a convenient way to transport their horses need the door-to-door care an ambulatory practitioner provides. Also, clients who could haul in their horses prefer the hands-on touch and personality of their favorite mobile doctor. When you send a horse to another doctor for radiographs or a special procedure, it doesn't need to damage your relationship with the client, Dr. Duplantis says. "Clients don't think my practice is deficient," she says. "They just think another person has equipment I don't have, and I can use it."

When she asks the university's ambulatory service to send someone to digitally radiograph a client's horse, that doctor takes the images with the mobile unit, burns them to a CD, and hands them over to Dr. Duplantis to decide on treatment with the client. "It's like leasing the equipment," Dr. Duplantis says.

WHY REFERRALS WILL HELP YOU

Sometimes you need to refer for medical reasons—complicated surgery, special diagnostics, or specialty services—but there are good business reasons, too. When you and your local colleagues develop referral relationships in a community, fewer practitioners are forced to spend the money to build haul-in facilities of their own. Also, not everyone needs to purchase specialized equipment that's used only occasionally. "Why do I need a room for surgery when somebody just down the road has it?" asks Veterinary Economics Editorial Advisory Board member Dr. Jim Guenther, CVPM, MBA, a consultant with Strategic Veterinary Consulting in Asheville, N.C.

When digital radiography was all the rage, Dr. Guenther says, the race for technology hurt some equine practitioners. Stables and horse shows often wouldn't use a doctor who didn't own digital radiography equipment. "It forced doctors to spend money, in some cases when they didn't have it," he says. When other practitioners develop specialties or haul-in facilities as their bread and butter, ambulatory practitioners can have the freedom to refer exceptional cases and keep clients patients happy and patients healthy.

REFERRED CLIENTS STILL NEED YOU

When you refer clients to another doctor, a university, or a specialty center, clients need the guidance of their regular veterinarian more than ever—for medical and financial reasons. They expect and need medical advice from you as their horse is diagnosed, treated, or examined by other doctors. But referrals can be expensive, and some doctors make sure their clients know it.

If clients tell Dr. Duplantis they only have so much money for diagnostics and procedures at a university or specialty center, she makes sure the doctors she refers to understand that. "The horse owner has ultimate choice over how far they want to go and what they want to spend," she says. "Every so often we send a horse with a money cap on it to a referral hospital."

Your clients know your competitors. When you can't make it out to the ranch, they call another veterinarian. But if you're their first choice for care, they like you. They respect you. That's why they give you their hard-earned money and ask your opinion on veterinary matters.

Even the best veterinarians refer their best clients somewhere else sometimes. So don't be afraid of referring. Embrace it. Let your clients know you'll closely follow the referred cases and talk to them about treatment. When those horses go home to the stable, yours will still be the name and number in the client's address book.