I’ve subscribed to the magazine Vanity Fair for decades. On the last page is a popular feature called the “Proust Questionnaire,” which has its origins in a parlor game popularized by the French essayist and novelist, Marcel Proust. He believed by answering these questions, an individual would reveal his or her true nature. Question nine is, “On what occasion do you lie?”
Probably the most common answer to this question is, “To spare someone’s feelings,” but when it comes to the practice of veterinary medicine, shame and guilt are the drivers behind most lies.
I’m speaking from experience on both sides of the exam table. I confess I have lied to veterinarians who were treating my animals. It was never in a way I believed compromised our animals’ health and well-being, but definitely in a way to save me embarrassment or allowed me to save face. That spared my feelings of inadequacy.
Are you thinking, “So what? Why is stretching the truth worth an article?” Here’s the reason: Because a pet parent not telling the “whole truth” to the veterinarian, veterinary nurse, or any member of the veterinary healthcare team, can have negative consequences for the pet, up to and including death.
The real “why?”
Let’s go back to my lies: Because I have felt embarrassed or ashamed, I’ve lied to veterinarians who have seen my pets or horses on exam.
I have fudged the truth about how “current” my pets are on their vaccinations (although conflicting recommendations blur this line). I have flat-out lied about parasite protection, which I “preach” should be given year-round but don’t actually give my own pets during the months when our mountain in Northern Idaho is frozen solid.
And while my wife, Teresa, is pretty darn dedicated to brushing our dogs’ teeth, not even she really does it every day. And our cats? If you predicted the number of times we have brushed their teeth is zero, you would be right. Zero. Zip. Nada. Not on your life, or mine. (We do give our pets “edible toothbrushes” at least daily and take them to the veterinary practice for regular checkups, digital dental radiographs, and dental work as needed, because we know how critically important good oral health is to overall health, happiness, and longevity.)
From one vet to another …
What’s more, I am not alone in being a veterinarian who knowingly and unblinkingly lies to another veterinarian. The whole premise for this article came from a dinner meeting at VMX I had earlier this year with about 10 veterinarians. None of them still practice, but instead work in the industry: advertising, research, government, organizations, consolidators, etc. All had pets and were consumers of veterinary services.
Maybe it was the drinks, or the fact it was kind of a humorous discovery, but almost everyone admitted either to not being rigidly truthful with the veterinarian on the other side of the exam room table, and/or delaying or not taking a pet to the clinic because of feeling guilty or embarrassed.
As one veteran veterinarian remarked sheepishly or sarcastically, I’m not sure which: “Do I want to follow my obese Lab into the practice and onto the scale, knowing what the body condition score will be and wondering if I’m going to be lectured and have Drake put on a prescription diet and be told to really limit the snacks he loves to much?”
You may be smiling reflecting on these descriptions of veterinarians who are not just veterinary service providers but consumers of veterinary medicine. What, if anything, needs to change?
Easy. We need to understand if veterinarians and veterinary nurses don’t tell the truth about their pets’ health, husbandry, and happiness (don’t admit their pets suffer from noise phobias from thunderstorms or fireworks, for example), then you can be as certain, the vast majority of pet parents withhold the truth because they feel guilty or embarrassed about their role in not following ideal protocols for preventing disease or injury when possible, and doing the best possible job of treatment when required.
Pet moms and dads assume most pet guardians are doing a better job than they are, and they certainly assume all members of the pet healthcare team follow best health protocols and practice recommendations to the letter. For example, all pets belonging to veterinarians and techs must get their teeth brushed, nails trimmed as often as needed, coats combed, and certainly would never be overweight or obese. Yeah, right.
To protect self-esteem, and to not feel like they are harming their pets by inaction or harmful practices, they do things like tuck medications in a drawer or cupboard instead of giving them to their pet, especially if the pet doesn’t like the medication, has side effects, or is stressed by taking it.
Like me, they stop giving parasite preventives when they no longer see fleas, ticks, or mosquitoes. They often vow to brush their pets’ teeth, but don’t even use dental chews on a daily basis—or at all! They stop feeding the therapeutic diet their veterinarians recommended for any number of reasons, or no real reason. And certainly they are prone to skipping those wellness visits we are always insisting they need.
What can we do to counteract these common tendencies that almost certainly cause harm or increased risk for the pet? Let’s look at the four examples I gave above one by one.
1) Medications. Be honest. Tell the client it can be hard even for people who work in the veterinary practice to give all medications as directed. We can use a compounding pharmacy to make meds tasty, we can give long-acting products, we can give meds on an outpatient basis, or we can even set them up with house call providers.
2) Preventives. We need to educate, motivate, and inspire pet parents to prevent problems. We need to convince them prevention costs less and spares their beloved pets unnecessary pain, damage, risk, or worse. For example, dental disease is much more than bad breath; untreated, it can cause your pet to suffer and die prematurely or unnecessarily.
3) Therapeutic diets. I now use home delivery companies to make compliance a no-brainer. During the yearly or twice-yearly wellness visits, we verify the pet parent is feeding the food, doing monthly parasite control, embracing daily oral care, etc.
4) Wellness visits. I have this down to an art form. First, the nurse or receptionist asks questions folks can’t answer “yes or no,” like this:
“We need to see Sparky for a recheck. What day of the week works best for you? Okay, Tuesday it is. Morning or afternoon? Since you picked morning, would 8 a.m. or 10 a.m. work best? To review, we have an appointment to see Sparky and you on Tuesday, October 12, at 10 a.m. Would you prefer a reminder by mail (have the pet parent write it out in their own handwriting), email, text, phone call, or more than one way?”
Consider you can’t leave the dentist, oil change business, or hair stylist without being asked to make your next appointment. We need to do the same. Book the next visit before they leave the current visit, every time, without fail.
More than anything else, by giving a pet healthcare mea culpa we close the distance between clinician and client and go a long way toward being seen as human, honest, and maybe even having a sense of humor about all of this. We know as parents, pet parents, and veterinarians living with the motto, “Do as I say, not as I do” doesn’t mean we don’t love our “kids” of any species! Let’s be honest with our clients about our own shortcomings, and invite them to share honestly with us about theirs.
Marty Becker, DVM, writes every other month for Veterinary Practice News. He is a Sandpoint, Idaho, practitioner and founder of the Fear Free initiative. For more information about Fear Free, or to register for certification, go to fearfreepets.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.