Friday, April 27, 2012

Real doctors treat more than one species


Someone posted this e-card on Facebook the other day, and I laughed out loud when I read it and showed it to two other vets who were in the building.

I was thinking about how vet school is a long, hard, grueling 4 years and how much each of us must want to be veterinarians, because that is the only way to get through. Sometimes I wondered why I was torturing myself so much, especially in the earlier years where we didn't do much with [live] animals. Sitting in class from 8 to 4, then studying from 4 to 11 was my usual status quo, at least for the first 2 years. And I know there were people who stayed up even later, and/or woke up earlier to get in a few hours of studying before class. Then in our clinical rotations, getting to school as early as 6 am to care for patients, working with clients and appointments all day while monitoring our in hospital cases and writing pages upon pages of discharge instructions, and staying until 10 pm to walk our dog patients, finish our surgery reports, then wondering why we should even bother going home and contemplating sleeping on the couches in the lounge downstairs. Four years to study countless species, anatomies, physiologies, normal and abnormal, pathology, histology, microbiology, parasitology, immunology, virology, diseases, zoonoses, behavior, preventative medicine, pharmaceuticals, public health, and about a million other subjects.

Then I thought about med school.

Four years, one species.

Today, a woman brought her golden retriever in for anal gland expression. She was a new client, and had never been seen by us before. Her dog was a total spaz for lack of a better word, and had clearly never been trained, socialized, or taught any manners whatsoever. I actually felt bad for her (the dog), because she was clearly very anxious and living that way is no fun for anyone.

Although it was a tech appointment, I ended up seeing her for an exam because the dog was acting like a bucking bronco and it was near impossible for the techs to express her glands. I examined the dog, who was on flea control only, no heartworm control, no parasite prevention, and was suffering from allergies. I spoke with her about sedation, which she did not want to do. She said she is always a bit "high strung," and even acts that way for her ears! No freakin kidding! We attempted expressing the glands one last time with the dog laying down, to which she eventually submitted. They were infected, and she also had an infection of her skin.

I spoke with the owner, recommended a skin cytology, antibiotics, heartworm and parasite prevention or at least a dewormer, to which she replied she had some antibiotics at home. Then came the dreaded words, "I'm a physician."

I explained why I would rather use the antibiotic I selected because it would affect both the skin and the anal glands. She said, "I can just prescribe some antibiotics for her myself, {silly little laugh}." I smiled, and said, "Don't tell me that." She declined heartworm prevention and the skin cytology, and when she saw the estimate for the antibiotics and dewormer, she declined both. She left just paying for the exam and anal gland expression.

I hope I never see her again.

I'm not sure what it is about human doctors, but they generally are horrible clients. Not all (I saw a wonderful internist on my internal medicine rotation whose cat we diagnosed with hyperthyroidism. He was very nice, despite feeling like he should have recognized the signs). But why are doctors so passive aggressive when they take their pet to the vet? Is it arrogance? Do they think they are better than us? Smarter? Most seem to think they know how to treat whatever their pet has, and have no qualms about prescribing medicines for their own animal. Which by the way, is illegal. MD's are only licensed to treat humans. DVM's, on the other hand, are licensed to treat anything but a human. Human doctors seem much more willing to blur the line between legal and illegal, or maybe they just think they know better. Most vets I know would never presume to choose their own antibiotic, or diagnose something in another human. (We may self-diagnose, I'll give you that, but in all fairness everyone self-diagnoses to some extent). Our response to human medical questions is "Go see your doctor!" In human medicine, doses are based on 'adult' and 'child.' In veterinary medicine, doses are based on weight. But doctors don't know this, because they only learn about one species. They don't realize that dogs are not humans, and cats are not small dogs. They learn next to nothing about zoonotic disease (diseases that can be transmitted from animals to humans). That's why veterinarians are on the front lines of public health.

Why do they get under our skin so much? Possibly because we hold them to a higher standard than the general public, and yet, we so often get let down. They should know what it's like when people blatantly disregard recommendations and fail to follow simple instructions. And yet...

In comparison, vets spend much more time explaining things to clients, looking at the whole patient, and thoughtfully choosing tests that will aid in the diagnosis but not break the bank. (A whole different rant, which others have already talked about here and in other posts). The point is, I'm proud to be a part of this honorable profession and wouldn't trade vet school for med school any day.

*All names and identifying details have been changed, and any resemblance to actual persons or events is purely coincidental.

4 comments:

  1. Brilliant blog article. So accurate. Ironically I have made the swap and am now in med school. But I have good foundations as a vet! Thanks for the entertainment.

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  2. Vets I know are quite happy to self medicate with animal meds rather than inconvenience of booking/attending a doctor appointment, so I don't believe there is a higher (or lower) ethical standard amongst vets than doctors.
    That said we're both commenting from personal experience and so small sample size bias is an issue, I don't know what the wider trend would be.

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  3. Yes, I'm sure there are people that do medicate themselves. And they are not doing themselves any favors, either.

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  4. Haha, I remember seeing that e card and I laughed so hard! I've been a veterinarian for six years now, and I remember how much I loved vet school. I attended St. George University in Grenada, West Indies, and within the first year, myself along with other veterinary students were already doing surgery and heading out on the farms to examine and tend to the animals. For my fourth year of veterinary school, I was allowed to choose what clinic or hospital in the world to shadow in. It all depends on what veterinary school you attend, I suppose. I also think it's quite humorous when a client (human physician or otherwise) begins to tell me what is best for their pet, like they've been through the grueling years of vet school. Just because you've searched your pets symptoms on Google doesn't mean you know everything about that specific animal! (Believe me, I wish it were that simple.) I always think "Don't speak to me about animal health unless you've received your accredited DVM degree!"

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