We often receive questions about “when to refer” a skin or ear case to a dermatologist. Our dermatologist, Mitchell Song, DVM, DACVD provides some tips below to help you make the best decision for your patient.

• If your patient has had three or more appointments in six months for the same problem and things are not improving. Many clients will leave a practice out of frustration if there is little or no improvement with a dermatology patient and go to a different clinic. It’s better to keep the patient and refer to a dermatologist.

• If a case presents that is outside of your comfort level or that you have less experience dealing with. Common examples include skin cancer, autoimmune skin disease, or any rare skin diseases, such as pagetoid reticulosis.

• If a case presents that requires special equipment, collaboration with another specialist, or advanced training to handle. Common examples include video otoscopy, Total Ear Canal Ablations (TECA), and cryosurgery.

• If a case presents with multiple comorbidities that may require special handling. These would include cases such as geriatric patients, dogs with Cushing’s disease, patients on chemotherapy, etc.

• Any patient whose owner asks for a second opinion to confirm your diagnosis or underscore your treatment plan.