Have you heard about “Martha’s Rule” being proposed for the NHS? It’s the idea that a patient should always have the right to seek a second opinion. Well, that already exists in the veterinary world! If your pet has an ongoing medical problem which is proving to be a mystery to your first opinion vet, they may advise getting a second opinion. Alternatively, you can request it; and they must honour your request and arrange it, in such a way that it would not harm your pet. However, sometimes your vet might recommend a referral instead – so what’s the difference?

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These two options are very different and below we will explain why. 

Second opinion

You can opt to receive a second opinion from another vet in first opinion or general practice. This may be recommended by your clinician if they know a vet who has recently performed a lot of research around a similar topic; has a significant amount more experience; or has a special interest related to your pet’s symptoms. The vet they recommend may even be within the same practice as the first vet you saw.

Second opinions may be carried out within your first consult where the vet takes your pet directly to another vet to gain their opinion. Alternatively, your vet may ask you to book a consultation with another vet on separate date and time depending on availability. If you are booking a consult, you may need to pay a follow-up fee. Your vets will always make thorough notes within your pet’s clinical file allowing other vets to see what has already been discussed and offered.

You can also seek a second opinion from a different vet if you are not happy with the diagnosis, advice or treatment given. You can see a vet within your usual practice or at another; but you must tell your vets that this is a second opinion, so that they can get access to the clinical records.

Referral

Your first-opinion vet may offer you a referral. This means visiting a referral vet. Referral veterinarians have often undertaken further training. This level of training will differ, and your vet should be open about their level of expertise. Some referral vets have undertaken a residency or even become a Diplomate and thus a Recognised Specialist. This normally means completing an internship first, comprising 4-7 years of additional training. Referral hospitals commonly have interns, residents and specialists who are dealing with cases all linked to a specific body system or veterinary field. Because they work in a niche area, they have carried out much more veterinary research within that field; therefore they have more specific knowledge. 

It is much more expensive to be referred

You should receive an estimate for the consultation plus any further work they hope to do before deciding whether to attend. Be sure to think logically before opting for referral work. You need to make sure the pricing is realistic for you; as there is always the chance the causative problem will not be identified. There is also the risk that the referral vet says the same as the first-opinion vet. 

A referral practice or hospital is likely to have more efficient and advanced equipment. This allows for quicker, more accurate diagnostic testing. You will sometimes be offered a referral for a specific procedure or surgery that your first opinion practice is physically not able to carry out. This makes them more likely to be able to find and treat problems. There are often multiple different areas of speciality within a referral veterinary practice; meaning if one department found something of medical interest that did not fall within their remit of specialism, they may perform an internal referral allowing the problem to be addressed during the same admit time.

You often need to travel further afield for a referral

Remember, there are fewer referral centres than regular vets, serving a wider area. Your pet must be fit to travel the distance. Because of this, emergency cases are often too critically ill to transfer. These hospitals normally have 24-hour care onsite and are huge! Most large cities have at least one veterinary hospital, but there are not very many compared to first opinion practices. 

Second opinion vets should not aim to take over the case unless you, as the client, decide you would like to change veterinary practices

Referral vets will usually treat your pet for this condition and work alongside your usual vet, not requiring a full transfer. Both options should be discussed with you and your vet should respect the decision you choose to take. Ensuring the veterinary practice has your pet’s clinical history is important in helping them analyse and determine the most likely outcome for your pet. Be sure to ring in advance to get this sent to another veterinary practice should you wish to get a second opinion or referral. There is quite a lot of difference between referral and second opinion. The main differences are price, location and level of specialism.

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