Referring clients to a specialist is a common and valuable practice that’s proven extremely advantageous for patient outcomes. It is also proven valuable for professional development and advancement.

The human health care profession has elevated patient referrals to a high level¹ that can be successfully incorporated into farrier practices. There is no need to reinvent the wheel, farriers can simply use it.

The blueprint for referrals² is elementary and given the elevated risk of injury, many farriers likely have personal experience. When visiting a general practitioner or family doctor during a checkup, a health issue may arise that requires specialized care that is beyond the scope of their practice and expertise. The general practitioner secures the patient’s confidence by explaining the need and rationale for referring the patient to a specialist. The general partitioner gathers all the available information about the case and finds a specialist who will perform the necessary work.^3,4

When transitioning the model from human patient to the hoof-care practice, the current farrier, the specialist and client meet to discuss the case’s details. The specialist’s entry and exit are defined, and the treatment protocol and execution are determined. It’s a blueprint that some farriers have found success with.

Lending a Hand

Strasburg, Pa., farrier Patrick Meck had just 3 years of experience under his belt and a client with a chronically foundered horse. Things were not going well.

“The case was way outside of my experience level,” Meck recalls a half dozen years later. “I was basically crippling this horse because I had no understanding of what I was doing. Finally, I reached the point that I realized I needed to call someone in.”

While calling in another farrier is the correct decision, it’s not an easy one to make.

“That was a big step for me, as a young shoer, to call anyone in because I knew how bad things looked,” he says. “I was scared to death that somebody was going to rip me a new one for my lack of knowledge and skill on that horse.”

Meck gathered his courage and asked colleagues for help.

“I showed the radiographs to a couple of farriers I worked with at the time and all of them said, ‘Look, this is beyond what we want to handle,’” he says. “One recommended putting the horse down.”

Although the farriers didn’t want to take on the horse, Meck wasn’t left hanging. One directed him to Lebanon, Pa., shoer Conrad Smoker, who has successfully worked on laminitic horses with EVA clogs.

“Conrad had every right to tell my client, ‘Look, this guy’s not doing good, sound work,’” he says. “Instead, Conrad took it as an opportunity to teach me and help the horse out in the process.”

It paid off for everyone involved. Meck and Smoker forged a bond that continues to benefit both. And the horse? The duo kept her going for another 7 years until the mare passed away at the age of 32.

“It wasn’t a fun go for her for a long time,” Meck says. “She was foundered for probably three-quarters of her life. When we started working with the horse, she had been a chronic founder for 10 years. It definitely worked out well for the horse.”

It also proved to be a learning experience for Meck that has paid dividends.

“I was so isolated before that,” he says. “I met some great farriers and started going to the International Hoof-Care Summit. Building those relationships changed where I am in my career. If in-ex-perienced farriers can learn that it’s OK to call someone else in, they’re going to improve sooner, the horse will improve sooner and it opens up a whole new world. No one should look down on anyone who wants to help the horse. If you take that step, you’re going to learn through that process.”

So, You Want to Specialize?

While Tom Curl has been a professional farrier for 50 years, the Vero Beach, Fla., shoer has carved a significant niche as a quarter crack specialist. His advice is simple — find a knowledgeable source.

“When you’re learning the quarter crack business, there’s not a lot of people you can talk with,” says the International Horseshoeing Hall of Fame member. “No books teach it anywhere. You have to work around somebody who takes the time to share it with you.”

After gaining the knowledge, use it.

“You need knowledge and experience,” Curl says. “From that, you’ll develop your skills. From your skills, you’ll get more knowledge and experience. But, you have to develop what you’re looking at. You can’t just experiment on severe cases or you’ll find yourself in trouble. Get some help.”

Patrick Meck found his niche by specializing in glue-on shoes. After becoming proficient at using adhesives, farriers in his area refer him to their clients.

That’s exactly what Meck did when he apprenticed with David Landolfi, a Dover, Pa., farrier who works exclusively with glue.

“I picked up a lot of knowledge and experience from him,” Meck says, “so I’ve been doing more of it.”

The learning process also can be pro-fit-able. Vernon, Texas, farrier Blane Chap-man has a close working relationship with many of the shoers in the Lubbock area. When they are in a bind, they often call Chapman to temporarily take over the case. However, they are encouraged to work with him on the case.

“I usually pay them to come help me,” he says. “We get to work together, bounce ideas off each other and help the horse out.”

Full Circle

Through the years, Meck and Smoker continued to work together on other horses. After learning about Meck’s work with glue-on shoes, Smoker approached Meck with a proposition.

“I can do glue-ons, but I don’t like to do them and I don’t like to keep the inventory,” Smoker says. “It takes me longer to do it, which costs me money. So, I refer my client to him.”

Before establishing the working relationship, it’s important to understand who you’re referring.

“You should learn about the strengths and weaknesses of the farriers in your area,” Smoker says. “Patrick and I have a good, trusting working relationship. He’s not trying to take my client and he can charge specialist rates because he’s being referred by the regular hoof-care provider.”

Although a client hasn’t suggested a permanent switch, Meck believes the onus is on the specialist.

“It’s all about professional integrity,” Meck says. “If a client approached me, I’m not working. The long-term game is, if I want to glue more horses, farriers in my area need to trust that I’m not going to run them down and I’m returning their horses to them.”

Detailing the plan of action with the client before work begins is ideal to ensure that everyone is on the same page.

“We’re upfront with the customer,” he says. “We tell them, ‘This is an in-and-out patient situation where we keep this horse going until your horseshoer can take it back. We’re going to consult with your farrier. We’re going to work on this horse, and this is how we’re going to do it.”

Maintaining an open and proactive line of communication is critical to success.

“We discuss the horse after each shoeing,” he says. “He tells me when it’s scheduled, its progress and what the timeline looks like for returning the horse.”

It’s equally important to have a strong working relationship with the client, so you can communicate the benefit of a specialist for their horse.

“Some clients don’t want anybody else working on their horses,” Smoker says. “But, if I tell them that having a specialist come in to glue on the shoes is a better option, they are more open to it. They have confidence in the job that he’s going to do and are more willing to pay the going rate for that kind of work. Patrick gets to do more of what he enjoys doing and I don’t have to do what I don’t enjoy doing.”

The benefits of recognizing and participating in our peers’ strengths include improved patient/client outcome, improved industry professionalism, as well as high-level continuing education.

References

1. Rosemann T, et al. Referrals from general practice to consultants in Germany: if the GP is the initiator, patients’ experiences are more positive. BMC Health Serv Res. 2006 Jan 19;6:5.
2. Javalgi R, et al. How physicians make referrals. J Health Care Mark. 1993 Summer;13(2):6-17.
3. Forrest CB, et al. Coordination of specialty referrals and physician sat-isfaction with referral care. Arch Pediatr Adolesc Med. 2000 May;154(5):499-506.
4. Forrest CB, et al. Family physicians’ referral decisions: results from the ASPN referral study. J Fam Pract. 2002 Mar;51(3):215-22.