Tuesday, September 25, 2012

Yo, Irreverent Vet! Over here!!!

Dude. I don't know who you are, but I just read your article over on petplace.com and I'm trembling with rage. So, I'm going to go through it point by point, if you don't mind - seems your blog doesn't really have any comment mechanism I can find so this seemed most efficient.

Your list of things that "Veterinarians Don't Want You to Know," with VBB commentary:

1. A Veterinary Hospital is a Small Business: Duh. Of course it is a small business. Unless, of course, it is a big business because it's one of those megacorporate monstrosities. But I digress. Most privately owned veterinary hospitals are small businesses. This isn't a secret. Most people of normal intelligence are fully aware of this fact. I know no veterinary practice owners who are trying to hide this. Do you?

2. There is a High Profit Margin on Vaccines: again not a secret. I've told people how much our vaccines cost. I've also explained some of the other points you bring up. People can decide what to do. I have never had a person refuse a vaccine based on our markup after I've explained what our markup actually includes.

3. They Want to Sell You Preventative Medication: Well, maybe they do and maybe they don't. Unlike some folks, I wouldn't deign to speak for all vets, but I personally would just as soon do away with the pharmacy biz. It's just that my clients find it a convenience, and if I don't carry these things, they get annoyed (heaven knows we get a ton of complaints if we are out of stock of something!). I'm sure some vets like to keep this business in-house, and that's fine too, but don't tar us all with the same brush, dude.

4. Vaccines Can Be Dangerous: Hello! McFly! Are you actually trying to hide this from your clients? Do you actually know vets who fail to disclose the potential risks associated with vaccines? What kind of scary-ass clowns came to your party? Oh. Oops. Sorry, got carried away there. But seriously - no. I refuse to believe that my colleagues do not disclose that vaccines can have adverse effects, and allow their clients to engage in informed consent. I am completely insulted that you disagree.

5. There is No One in Our Hospital Monitoring Pets at Night: Again with the failure to disclose! Seriously? I find myself fighting with clients who want me to admit their pets to our day practice, literally yelling "BUT WE HAVE NO ONE HERE TO MONITOR YOUR PET AT NIGHT!" and they still want to have the pet admitted. I certainly would never in a hundred and fifty billion years consider admitting a pet and keeping the unmonitored overnight status on the downlow. Where do you practice anyway, that you think this is normal behavior?? Are you in Dr. Pol's neighborhood or something?

6. Vaccine Recommendations Have Changed: ok, at least you say "some" vets are still giving annual vaccines instead of longer vaccine intervals but again - this is not a thing that "Veterinarians Don't Want You to Know!" You make it sound like there is some big conspiracy and that most vets are hiding these facts from their clients! 

7. Vets Often Don't Agree With Breeders: I'm gobsmacked. You seriously think that vets do not want their clients to know that we often disagree with breeders? I would like to see a show of hands from the readership... who here finds him or herself telling a client that the breeder is wrong at least once a day?? I know I do. 

8. There are Some Things Some Vets are Better at Than Others: Were you running out of things for your list? This is just silly. No one individual is equally good at absolutely everything he or she does, and only a complete blithering idiot of a client is going to assume that he or she is. This is not a secret. 

9. You Have Referral Options - I guess maybe there are some vets who hesitate to offer referral, as you say. I'm not one of them but whatever. I'll give you this one. 

10. I'm not that Familiar or Fond of Alternative Medicine: Er - it's true I've never told a client your opinion of alternative medicine. But, they will get an earful of mine - which is essentially "show me the research, if there isn't any and it seems harmless fine, if there is some and it shows efficacy, fine, otherwise, no, stay away."

11. Most Vets in General Practice are "GP's" : Are you kidding? I am starting to wonder if you have a different way of defining 'don't want you to know' than I do. Like the many colleagues I speak to on a daily basis, I am frequently telling clients that I am a GP, and that I would really prefer to consult a specialist. Most of the time they reply "oh Dr. VBB - we really only trust YOU." To which I reply "well, if you trust me, take my advice and see a specialist!" to which they reply "oh no, we could never let any other doctor see Fluffy." *headdesk*

12. Vets Have a Low Tolerance For Aggression: Funny you should bring this up. This week I have told two puppy owners that their new puppies showed unacceptable amounts of aggression to me and that they need behavioral consults. My clients are well aware that aggression is not amusing or acceptable in my exam room. I don't jump to euthanasia as a first line of treatment for aggression, but I definitely have it on my list of treatment options, and if dedicated behavioral interventions fail or are refused, better to kill the dog than the dog kills a person. And I'm not afraid of using muzzles or chemical restraint if necessary. This is all explained clearly up front. No one who has been to VBB central with an aggressive dog comes away misunderstanding this. 

13. Vets Get Attached: Not sure why this is even on your list when you state right there that we sometimes cry. Hard to be keeping it secret when you're crying in the exam room with your client, really. But, I don't know any vets who think their clients shouldn't know how much they (the vets) care about the client's pets. Why would we not want people to know this?

14. Vets Have Bad Days Too: This is kind of right up there with number 11 and number 8 and number 1 as not really something that a normal person of average or better intelligence would not know, and not something that anyone is actively trying to keep secret from his or her clients. Whatever.

15. Cats May be Happier as Indoor/Outdoor Cats: OK, you got me! I do know some vets who would never ever be willing to state that it's ok to let your cat outdoors due to the associated risks. Good work, Irreverent Vet! Now the people know.

16. Your Dog Doesn't Need Vitamins: again, not a secret, not something anyone I know is hiding from people, actually something I tell people all the time and the people choose not to believe. 

17. Not all Foods Are Created Equal: also not sure why this is something you say vets don't want people to know....just seems like list filler. 

18. All Drugs Have Side Effects: see item 4. OF COURSE this is disclosed! 

19. If Your Dog Acts Aggressive We Muzzle: See item 12....

20. Even if Your Dog is Really Bad They May Minimize It: so you see a lot of vets shooting themselves in the foot this way? I don't. I just tell people "your dog's behavior is not acceptable" and then explain why and what needs to be done. Seems many of the vets I speak with regularly do the same....

21. No House Calls: how is this a secret? Obviously if people call and ask for a house call and that's not a service you provide, you tell them, right? How is this something we don't want people to know? Are you saying we just want people to go around assuming if they call us we'll drop everything and run over? Why would we want that? It would just end up in disappointment and anger. 

22. Many Pets Do Better When You Aren't Around: again, not something we don't want owners to know. This is something I tell people All. The. Freakin'. Time.

23. We are Often People People: Not touching this with a ten foot rabies pole :)

24. Vets Hate Talking About Money: ok this is a true statement, but I wouldn't say it is something we don't want people to know. 

25. Vets Aren't Always Right: Sigh. Again with the statements from the Department of Obvious Facts. See #1, #14.... Also not a secret.

26. Pets Can Change: again a true statement, again something I find myself explaining OVER and OVER to clients who JUST DON'T GET IT. So - I'd call this something vets DO want you to know, not something vets do NOT want you to know. Did you get your columns mixed up?

27: Vets are Not Nutritionists: well, some are. The GPs aren't, though. That's true. This is no secret in my practice, but I don't discuss it with a lot of other vets so couldn't say what is generally done. In my practice, I will offer to help with basic dietary stuff, and have sometimes consulted a nutritionist for assistance (at the school where I trained), and have made referrals to nutritionists. Tell me more about how the vets you know keep this hidden from their clients, though! Sounds like a great story hiding behind this.

OK, well - this is all I have to say. Feel free to explain yourself in the comments!


  1. I personally wasn't trembling with rage when I read the article. In fact, I think the article was simply mistitled. It should have read "Things Your Vet Desperately Wants You to Know and Accept!" - with the exception that #20 is downright wrong....I mean, seriously? Why would Irreverent Vet think that these are things we don't want our clients knowing? Unless Irreverent only talks to the segment of the profession that doesn't like to actually explain things to their clients and wants to be treated like god....

    1. Hmm. Maybe it wasn't rage. Maybe it was too much coffee. It was still a crappy article.

  2. WTF.... it won't let me read the article, but OMG. It sounds like I definitely won't like this person. Who doesn't disclose drug side effects??

    1. Won't let you read it? Let me give you a couple of excerpts. Number 1: "Most vets don't want to talk about this – but a vet hospital or clinic is
      a small business. It is like any other business that requires money for services rendered. It is sometimes hard because vets love animals but they also have bills to pay. They can't give away services and still be able to pay all the bills and employees."
      Number 4: "There are some reactions to vaccines that can be life threatening. They are reactively uncommon but when present can be significant. Some pets will have mild allergic reactions and other can have an immune mediate response or develop a tumor (cats). In general, most veterinarians believe that vaccines do way more good than harm and they often don't emphasize the uncommon reactions as they should. I think they don't want to scare people away from something that has clear benefits."

    2. I think the above commenter had it right - the article WAS mistitled.

  3. Where does I.V. practice that this is the *norm*? I am in agreement with you VBB. My clients probably think I explain TOO much, but better that they are informed and educated as it makes my job and their pets' health so much better!

  4. Sorry, on this one I've got to say you might have overreacted - I really think the title was written tongue-in-cheek and the author is actually trying to give out common sense information to the public. Maybe read the article all over again but imagine it was titled "Things you should know about vets"

  5. as a client, I can tell you that I quite often haven't been informed of side effects of vaccines or drugs prescribed. the down side of metacam has been downplayed. VAS wasn't even discussed - I first heard about it from someone who's cat got it.

    and how many times are we told to discuss our pet's diet with our vet?? I have had vets simply spout back at me the tag lines from the major pet food manufactures and tell me there is no difference between wet or dry food except water content (and who wants to pay for water) (SERIOUSLY!??!)

    I don't think the person who wrote the article was right in any way shape or form - with the tiniest exception that it gets people talking about things.

    1. I think that it is easy for those of us in constant contact with other professionals all over the world, having great conversations and consults on cases, to for us to forget that not all vets constantly keep up with things. Sorry that your vet does not. All of my vet friends have exhaustive handouts and conversations with owners. When I was full time emergency, I always talked about VAS and diet was HUGE with us because we formulated diets to make sure that the were part of helping. Honestly, there are several of us that contribute to this blog and I have to say, I know that I have read their cases and consulted with them on my cases and they are fabulous. So, while we might be GPs, we are surrounded mentally by other vets that are keeping up and trying to do all of these things. It is not totally surprising that we assume that others do this too. Maybe naive, but there you are. Since my cohorts in the VBB try to be as transparent with their clients as possible, I tend to start thinking that all vets do this too. And they should.

  6. This is insane. What an absurd article and a ridiculous author.

  7. I think PetPlace needs to add number 16.

    16. Nothing said above really matters to anyone except to piss off nice Vets who really care about the animals they treat.

  8. I have never had a vet speak about side effects of vaccines or medications, unless I asked. But neither do human doctors. The thing is, all vaccinations and medications have some possible side effects. I don't think vets are hiding them, but most side effects are rare or minor, and they just don't automatically list them all. I would hope that if there are more common and serious side effects, that a good vet would mention them. If I want all the details, I ask or look them up somewhere reputable.

  9. I used to work for a vet who would tell the owners of severely aggressive dogs that they behaved "pretty well" in the back for us even if we had to shoot them with enough Ket-Val to fly a kite just to let us touch them. I always thought he was an idiot, and I'm supremely glad I don't work for him any more.

  10. Maybe its supposed to be titled "I'm a shitty vet and here's what I think you don't know about my practice"

  11. VBB- You can contact the author, there is an email contact form link on one of his other articles about "What if you think your vet made a mistake?"

    It's an odd article, because if it is meant to be tongue in cheek it almost isn't tongue in cheek enough!

  12. 2. kind of surprised, since vaccines are quite dirt cheap anyway ...?

    4. I have to tell you that NOT ONE vet we've been to in the past said a single word about ANY potential vaccine risks. Not a single word, and that's the truth. Not even to the extent of "this might sting a little." NADA And those were "normal" pet clinics (no low cost, no cooky "got my degree on the Mars" types.

    Daughter's Chi was even administered a non-core vaccine daughter specifically asked not to be given and the Chi almost died to a resulting severe reaction. I'm not kidding here. (It was lepto btw)

    18. About the same thing as with the vaccines. About all the disclosure one often gets is "give this three times a day." Not kidding either.

  13. "Taking veterinary advice from a breeder is like getting gynecological advice from a pimp."

  14. I also want to chime in about not being told about side effects from vaccines. Many years, many pets, never have I heard a warning about side effects. Though, I *do* understand anything can happen, since I am an adult human who has lived in this world all my life.
    And VAS in cats? Thanks to this article, I Binged it (not a Google fan.) and learned something new. So thanks for that.