Casual Aside

There are things we say that get us in trouble. We often don’t think anything of them, just mention them in passing, often something stated as a way to relieve stress or take a stab at humor or to provide perspective on something.

As a afterthought I can think of 3 times that this has been an issue in veterinary medicine for me and others. One that came home to me was when I had an afterthought interaction with a very sick cat where I attempted to examine a wound in its mouth and when it practically passed out due to basic manipulation I stopped and called its caretaker to discuss the situation. While it was happening, one of the other veterinarians I was working with commented in a dry joking manner “I see you are doing non-anesthesia dentistry there.” And as I was on the phone with my client I had to take the phone into another room because of a sudden burst of noise that occurred.

As it turned out (the cat had to be euthanized due to a not yet determined significant occult illness) over a month later I was called on the carpet by not only our hospital medical director but the regional manager as well about the “cat who I killed” seemingly inadvertently. They had taken the word of a suspicious staff member having misinterpreted my colleagues words and thought I was hiding my discussion with the client to make it look like I had not caused its distress. And took it upon themselves to review the record (nothing was there) and interview the employee and finally ask for my side MUCH later. The whole time I had no idea. If they had asked me right off I can only imagine it wouldn’t or at least shouldn’t have been a big deal.

The other two situations had to do with overheard stressed frustrated vet comments overheard by staff, I am going to imagine. Only they know how truthful the situations were, but my role led me to believe there wasn’t much merit to the allegations made. In one case a veterinarian was thought to have a special “PIA” (pain in the ass) fee for certain clients and in the other the doctor had significant medical needs and was believed to be taking narcotics which were effecting her ability to perform her job duties. On closer inspection that didn’t appear to be the case, though an employee did say that they had been heard to say “It’s 5 o’clock, almost time for my vicodin” which was damning.

Ultimately, though we are people too and in stressful jobs, we as veterinary professionals need to remember that ALL of our actions are taken very seriously by those around us and we have to keep our actions above reproach at all times.

Otherwise …

WIHCTU

Keep your manners and wits about you at all times and you won’t have any ‘splainin to do (remember I Love Lucy?)

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Surgery went “well”

All things medical can be a dicey proposition. As a professional I can not ethically make any guarantees of the outcome of any test or procedure. We discuss liklihoods. Based on the knowledge we currently have or experience that has been brought to bear. Surgery is where this comes true more than any other area.

Buzz words abound: routine, as expected, nothing out of the ordinary occurred. But there are so many ways that the surgical process can go awry, and clients/patients are understandably wary. And they don’t know all there is to know about these things. They rely on the medical people to do what they say they will (and what was that exactly?) and hope for the best possible outcome. On the medical side we do things so often we don’t think much about the bad possibilities, often not fear what can go wrong.

What I have come up with, having worked with animals for going on 30 years over half of them as a veterinarian, is that equal parts to how a patient does medically/surgically is shared 3 ways: me (the hospital experience, my surgical skill, our team etc.), the patients inherent ability to heal not to mention deal with the process including anesthesia, and the client who plays a key role in following instructions and administering medications and being watchful for things going awry. If things don’t go well we all have different psychological mechanisms that drive our behavior.

Some vets assume it was all their fault, others don’t imagine that anything they did could have been a problem. I personally feel you should learn from each circumstance in order to help that patient and others that follow. There is a fair amount of soul searching involved – “could I have caused that pets injury or demise?” It can be a sobering process.

The reason this comes up at this time is a patient that has had 4 surgeries at this point we are currently treating. The first surgery did not go well and ever since we have been fighting the results. There are $ considerations and every time the client states that she will have to euthanize her pet friend “next time” but has ended up not being able to do so. Most recently a specialist surgeon did some of the work. Hopefully for the final time (hope, hope, hope!!!). According to this client I can do no wrong. To myself I wonder if I haven’t terribly failed and put the patient through a horrible experience that is all my fault not to mention spent a bunch of my clients money that she didn’t have. Sigh.

WIHCTU

A little bit of fear can be a very educating thing

CS

Inspecting

My most recent career arc has added inspecting veterinary hospitals. I was asked to do the job. Strictly flexible and on a consultation basis so that it doesn’t have to interfere with anything else I do. Originally I wanted to go through the training and see if my own hospital was up to snuff and then decide if I wanted to do it. Much to my chagrin it turned out we needed some help. Doh!

Then before I could accept the position I was told I was an inspector and handed a to do list. Well, ok, no big deal because there was no time expectation. When I got done with the few they assigned (this is the state) I would turn them in and get a few more. And their are some cool parts. I have a state ID which has some benefits. A discount at hotels. Some other paid things, meals etc.

I do get a ‘you will respect my authoritah!” sensation a la Cartman on South Park for some reason. And I am on the inside to expectations and changes as to the rules that regulate veterinarians and the standards they are held to. Thus I have to keep myself there if I am going to tell other vets what to do.

Ultimately it is a fascinating job and I realize I do a necessary important and educational thing for other veterinarians and by extension the patients they care for. So I am helping the pets in another more significant way. And most, probably 90% of veterinarians want to abide by the rules. They just don’t always know what they are. And the others really need to get up to speed or the veterinary medical board needs to know about them.

Now I give talks to veterinary groups about how to prepare for inspections, and perform complaint related inspections all over the state. It all really is very satisfying.

WIHCTU

Regulation is not necessarily a bad thing for all involved.

CS

Testing

I’ve come here today now to share with the world some things I’ve been thinking about but never knew where to put them.

All things veterinary, great and miniscule. From a list of stories I’ve compiled in my email folder “Journal” – originally intended to house various interactions I’ve had in my life in veterinary medicine to share with those of my family to learn who come after me. To get to know a little something about me.

Also included would be the various humorous asides that come on a day to day basis. Spoken by our earnest clientele and employees. Sometimes the humor is obvious, other times one has to be there or take part in what we do to truly enjoy it.

But the expectation in sharing is to explain it as well, reflect on what is stated. Provide a moral without moralizing.

And perhaps also be able to educate which is our primary goal in veterinary medicine: clients about their pets, teaching all levels of people we come across and work with, as well as about ourselves in how we handle the daily trials and tribulations which working in health care brings.

This is what we are here to do.

One can also find us at Friends of Noble Vet on Facebook and @Noblevet on Twitter.

Sincerely,

Carl Singer DVM