With many veterinary practices becoming incredibly busy and lots of new veterinary practices opening up, you may have found yourself hunting for the best local veterinary practice for you and your pet. When looking on different practices’ websites, they will advertise different services to explain how much they are able to offer you and your pet. One thing you may have seen is their ability to offer “internal medicine” treatment, but what does this mean?
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Although it sounds like, logically, all medicine (except dermatology!) should be “internal”, in actual fact this is a very specialised discipline. Internal medicine involves the prevention, treatment and diagnosis of internal diseases. Diseases included in this area can influence many of the body’s systems; and so can be complex, requiring expert knowledge to successfully treat them. In many cases, we would consider internal medicine vets, or internists, to be those whose job it is to pull together multiple different medical specialisms.
Most vets in general practice are generalists. This means that most are quite capable of managing the majority of internal medicine cases. However, when things are more complex someone with further study and qualifications in the area can be invaluable.
Further qualifications
Qualified vets may choose to continue to study in certain areas; such as internal medicine to gain further knowledge and qualifications. Vets may complete extra certificates, internships and residencies in order to continue their professional development; and to become more knowledgeable in specific areas of veterinary medicine. If a vet gains a Certificate in Advanced Veterinary Practice in Internal Medicine, the veterinary profession will acknowledge this by saying they have a ‘special interest’ in this area of work; and they can go onto the RCVS Register of Advanced Practitioners.
For a higher level of expertise, the vet must usually complete a residency, pass an RCVS or European Diploma, and demonstrate their fitness to be registered as a Specialist. Interestingly, it is a disciplinary offence for any vet or nurse to refer to a colleague as a ‘specialist’; unless they are on the RCVS List of Specialists!
Second opinions and referrals
As veterinary professionals, we are obliged to recognise our own limitations. And offer referral or seek further advice should a medical condition require more knowledge or experience than we feel capable of providing. For a referral, you would normally have to go to the expert, but second opinions can happen remotely.
If you are lucky enough to have an Internal Medicine Advanced Practitioner or Specialist in your own practice, it’s much easier, as they are available to their colleagues pretty much as needed.
Referral centres and hospitals
Internal medicine specialists commonly work in hospital environments. This allows them to utilise their knowledge from more complex cases that first opinion veterinary surgeons may have not been able to gain control over. They may be able to offer additional treatments due to having more advanced equipment. Commonly seeing disease processes that have resisted first line drugs means internal medics work with multiple, much more rarely used drugs daily. And they become very familiar with new drugs, their side effects and which drugs work best for specific cases. Larger practices commonly have access to a wider range of drugs in house; compared to smaller practices who may need to order less commonly used medicines into the veterinary practice prior to dispensing them. Some first opinion practices will have veterinary surgeons with a special interest in internal medicine. And therefore may be able to offer further advice in this area.
Receiving further teaching and experience with internal medicine is very valuable. Although all veterinary surgeons will have a solid base knowledge regarding medicine and which drugs, diagnostic testing and prevention methods can most appropriately be used. Referral to a hospital with many specialists from all backgrounds is always an option that should be considered if your pet becomes ill and warrants further investigation or treatment.
To conclude, developing further understanding into internal medicine is important within the veterinary world. Although when selecting a practice, choose somewhere you feel is affordable; somewhere you can get to quickly should your pet need emergency treatment; and a practice who has availability for appointments so you can be seen if you need to be.