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Veterinary Practice News Editorial Blog:
Thursday, Oct. 22, 2009
The Triangle of Care
By Katherine Dobbs, RVT, CVPM, PHR
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The Triangle of Care is a concept that came to me during my years of being on both sides of the referral equation: as a technician in general practice that referred patients to specialists, and then as a manager in a referral hospital. The triangle consists of three points: the general practitioner or family veterinarian, the specialist or emergency clinician, and the pet owner.
In the middle is the pet, the animal that is central to all we do. The hope is that this triangle remains balanced, that the relationships on each of the three sides are respected and enhanced through the referral process.
We are not alone in figuring out how to make referral relationship work best. The AVMA approved Guidelines for Referral in 2004, and the AVMA Principles of Veterinary Medicine Ethics revised in 2008 also contain specific instructions regarding the referral process.
In 2006, the American Animal Hospital Assn. (AAHA) published its Referral Guidelines, which go into more detail on how the two practices and the veterinarians should communicate on behalf of the client and patient. AAHA took it one step further by hosting forums with general practitioners and specialists in attendance to discuss the most common communication issues.
The white paper that resulted from these forums, “AAHA Focus on Referral Issues,” was published in 2007. The paper sheds even more light on ways we can deal with common issues that arise during the referral process.
Last night I hosted a VIN Rounds on this Triangle of Care. It continues to surprise me that many people are unaware of these documents that can help our teams understand this referral relationship.
Today more than ever, our teams want to understand WHY they are asked to do certain tasks in a certain way.
- Why is it important to fax referral reports the same day as the appointment with the specialist?
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- Why is it important to know which of your doctors are board certified, and which are not yet?
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- What information does the referral practice need to share with the general practice so it can educate clients?
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- How should our front office react when a self-referred pet owner comes to the specialty practice?
Some of these answers will depend on the opinions of the veterinarians involved in the pet’s care, but we have guidelines that at least give us a place to start answering these questions and more.
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