Wednesday, November 5, 2014

A worthwhile thing

Last week Tess saw the vet. It was her first nothing-is-actually-wrong-with-the-dog general "wellness" visit, even though she's 3 1/2 years old. 

As most of you know I'm a vet student. Do you think it's odd that I don't blindly follow the recommendations of the various professional organizations statements bombarding us students? 

Yearly annuals for all pets! 

Feed store vaccines from pet stores are useless!

Tarter removal not done under general anesthesia is fraud!

The medications you get at online pharmacies are tainted!

Dog foods are all the same!

I think that a lot of the recommendations are manipulative - we tell owners to do this because it causes them to do this and that's the real reason they need to that, but their brains (and yours, you poor little vet student) just simply can't handle the complexities of why so don't bother explaining it. 

In truth, I find the small animal veterinary world a little insulting after residing in the large animal one for so long. 

It's not just the veterinary world - it's the drug companies too. When sitting through small animal sector drug company presentations, in general the reasons I hear why a certain thing should be prescription or why the new product is better than the existing ones on the market is because of control. It's something the pet owner can only get at the vet. There may be other reasons (efficacy, safety etc) but these (at least in my experience) are rarely emphasized. Contrast that to large animal sector drug companies. In general new products are presented as making up for the deficiencies (ease of administration, better working etc.) of the current products on the market and the emphasis is on client education. 

I dislike being manipulated and controlled, and that has been my overwhelming experience when I take my dogs and cats to a small animal vet. 

The final nail in the coffin of why my pets don't get an annual "wellness" exam is that I'm tired of paying for physical exams that never actually happen. 

If I bring my seemingly healthy happy (friendly) dog into the vet office and a physical exam does not occur - not just a cursory exam of "is this animal healthy enough for the meds/vaccines today" but an exam that asks the question "is there something wrong minor today that we can catch before it's a major issue in a year" - then what I've done is pay a fee to have a medication (such as heartworm preventative) dispensed.

Not cool, especially because one of the heartworm medications is a combination drugs that are easily obtained over the counter for large animals - just not for small animals. 

So why is this post titled a "worthwhile" thing? Because while doing a small animal externship locally over the last couple of weeks, I *finally* found a small animal vet that I felt made it worth my time and money to pay for a yearly exam on my dog. 


She actually DID a physical exam. Yes, even the distasteful parts that are relatively unpleasant for both dog and vet, like getting a good look down the ears.  

Even if she hadn't found anything I would have been satisfied, knowing that there was nothing major I had missed, there was no additional procedures (like ear cleaning) I should be doing throughout the year. A verdict of "everything looks ok" when things were actually looked at is as valuable as finding something wrong. 

But she DID find something. 

In an otherwise beautiful ear (Melinda, you have to take a look down her ears. They are the best you'll see! - we see a lot of nasty ears) were nasty little foxtails. They hadn't been there long, but they didn't just get there yesterday.

Potential problem averted. I had no idea they were there - no head shaking, head tilt, scratching, smell, or debris.

Since I was already at the vet, I went ahead and asked for a Heartworm preventive medication (it's cheap and I had already paid for the exam so why not?!) and a new oral tick preventive since Tess is getting more and more itchy and uncomfortable with topicals.

Drug companies and those lamenting the lack of clients willingness to come to the vet office, you've got it all wrong. Forcing clients to show up at the vet to get the fanciest preventive medications and vaccines is not the secret to getting the educated and finance-conscious clients to show up at the vet and part with their money.

Increasing the value of the exam will (but you actually have to do one first).

As a bonus, findings during the physical exam will likely result in some sort of additional procedure/revenue.

And, since the clients are already in the office, they are more likely to purchase those fancy products.

Finally, perceiving the experience as a good value and a "smart decision" will result in better compliance.

As a manager I quickly learned that most complaints I had about the employees working for me likely originated in me, not them - communication, approach, philosophy. I can't help but wonder how much of the struggles I hear voiced in the small animal veterinary industry in particular is due to this. As a student, I'm not "in the trenches" dealing with these issues on an every day basis, but I do get to watch a LOT of vets interact with their clients as a "fly on the wall" and I can tell you what works and what doesn't. Combine that with my own experience on the other side of the table as a critical-thinking, skeptical client, and I think it gives insight into what policies and procedures are likely to help, not hurt, the business of the small animal veterinary hospital.