{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:01:26Z","timestamp":1790866886363,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Vet. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As demand for specialised veterinary care increases, referrals between first opinion practices and specialty clinics are becoming an increasingly important part of the chain of care. However, care pathways between these two settings can involve multiple transitions back and forth, each representing a potential opportunity for error or information loss. Issues such as communication failures, lack of information transfer, and delayed discharge letters back to the first opinion practice may occur, potentially compromising continuity and quality of care. Characterising veterinary surgeons\u2019 satisfaction with this process is therefore an important first step towards identifying where these risks arise and how they might be addressed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate the status quo of the referral process and veterinary surgeons\u2019 satisfaction with it in the German-speaking DACH region (Germany, Austria, Switzerland), in order to identify communication and information gaps along the referral pathway and inform recommendations for improving collaboration between first opinion practices and specialty clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online questionnaire was distributed among small animal vets in Germany, Austria and Switzerland. Data from 657 general practitioners (GPs) and specialists (SPs) were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of veterinary surgeons were generally satisfied with collaboration within the referral process; however, GPs rated cooperation more favourably than SPs. A clear lack of information within referral letters was identified, including medical history, medication details, clients\u2019 contact details, and specific clinical questions. Participants considered good communication, professional skills, and timely discharge referral letters to be the three most important aspects of collaboration. According to GPs, discharge letters were received in 90% of cases, while according to SPs, discharge letters were sent in 80% of cases. The most common problems identified were delayed discharge referral letters (56%), communication failures (55.7%), and missing information (49.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although participants expressed overall satisfaction with collaboration in the chain of care, problems arise at several points along the referral pathway in the DACH region. We recommend the development of unified referral guidelines within good clinical practice schemes, ideally regulated by relevant authorities, specifically addressing information exchange within referral letters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fvets.2026.1748365","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:46:52Z","timestamp":1790866012000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The veterinary referral process in the DACH region: survey-based insights into obstacles and motivations"],"prefix":"10.3389","volume":"13","author":[{"given":"C.","family":"Gast","sequence":"first","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"Hassenstein","sequence":"additional","affiliation":[{"name":"Institute of Animal Genomics, University of Veterinary Medicine Hannover","place":["Hannover, Germany"]},{"name":"Unit for Research Data Management, University of Veterinary Medicine Hannover","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kleinsorgen","sequence":"additional","affiliation":[{"name":"Centre for Teaching, E-Learning Services, University of Veterinary Medicine Hannover","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Busse","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. A.","family":"Volk","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"ref1","volume-title":"Tier\u00e4rzte Atlas Deutschland 2024: Daten, Trends und Entwicklungen der Tiergesundheitsbranche","author":"Held","year":"2025"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"11871","DOI":"10.1038\/s41598-025-95515-8","article-title":"Similarities and differences between dog\u2013human and human\u2013human relationships","volume":"15","author":"Turcs\u00e1n","year":"2025","journal-title":"Sci Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4454\/db.v3i2.51","article-title":"Factors affecting the client-veterinarian communication and breaking bad news in companion animal practice in Italy","volume":"3","author":"Cipolla","year":"2017","journal-title":"Dog Behav"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.2460\/javma.23.01.0046","article-title":"Client perceptions improve with collaborative care when managing dogs with cancer: a collaborative care coalition study","volume":"261","author":"Morello","year":"2023","journal-title":"J Am Vet Med Assoc"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"715","DOI":"10.2460\/javma.23.11.0612","article-title":"Do it yourself or send for help? 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