Weighing the changes raised by specialty practice

TWENTY-SEVEN PERCENT OF VETERINARIANS responding to the 2006 Veterinary Economics Industry Issues Study say they refer six to 10 cases a month. And clearly, the growth in available specialty care changes the market and the standard of care for communities. How is this transition changing day-to-day business for primary care practitioners?

The 2006 "State of the Veterinary Profession," a study conducted by DVM Newsmagazine, reports that veterinarians intend to develop greater expertise or expand their services further in dentistry, internal medicine, surgery, and radiology. (See "Beyond Basics")

The change may reflect practitioners' recognition of clients' growing acceptance of specialty services. Or it could be, in part, a competitive issue; 6 percent of veterinarians surveyed in the DVM Newsmagazine study feel that specialty practices pose the most significant challenge to their practice.

Figure 1 The source of reluctant referrals

While only 3 percent hesitate to refer because they worry they'll lose the client, it's true that specialty practices earn a significant portion of their revenue from sources other than specialty care. In fact, small specialty practices earned $81,000 from other sources during a fiscal year, medium-sized practices earned $880,000, and large practices made $1,241,000 from other sources, according to the "Specialty & Referral Veterinary Practice Benchmark Study," released by AAHA in 2005.

What's the holdup?

Twenty-seven percent of respondents to the Veterinary Economics survey say the nearest specialty/referral hospital to their practice is fewer than 10 miles away. This certainly makes referring for ophthalmology, neurology, orthopedics, and cardiology convenient for these veterinarians and their clients. However, 31 percent say the nearest specialty/

referral hospital is more than 30 miles away, and 39 percent say the distance to the nearest specialty practice causes them to hesitate to refer a case.

Still, cost takes the No. 1 slot when we asked primary care practitioners why they hesitate to refer clients to specialty practices. Eighty-two percent of respondents to the Veterinary Economics study say one of the reasons they hesitate to refer is that clients can't afford the care. Yet only 24 percent say they believe specialty care is overpriced. It seems specialists are aware that cost is a key reason for hesitation. Seventy percent of specialists surveyed say they think primary care veterinarians hesitate to refer because their clients can't afford the care. (See "The Source of Reluctant Referrals.")

Figure 2 Beyond basics

You see a bigger gap in perceptions about the potential loss of clients. Half of specialists believe this is an issue, but only 3 percent of primary care practitioners say it is. And specialists' frustration with this issue is evident, as with this comment: "The fear that they'll lose personal income is overriding the need to offer what's best for the pet."