Confronting a Complex Issue I am compelled to write in response to your article “Confronting Suicide” [March 2016] by Dr. Lou Anne Wolfe. First, I would like to say that I do not know any of the deceased referenced in the article, and I write only of my personal experiences as a veterinarian. The article not only misrepresented veterinary professionals but also discredited the profession by stating that veterinarians “are not used to failing” as one explanation for suicide. I would venture to guess that most veterinarians would agree that that statement is a gross misrepresentation of the problems we face and in no way begins to explain why someone would take his or her life. It’s not about failing; it’s about real problems inherent in veterinary medicine. For example, there is a complete lack of a support system among veterinary professionals, particularly if one is a solo practitioner, like me. For those of us involved with rescues and shelters, there’s the endless stream of neglected and homeless animals, what sometimes seems like a hopeless animal overpopulation problem, compassion fatigue, long hours and intense physical demands, juggling client money constraints with the “good medicine” philosophy, client ignorance with respect to animal health and welfare, and an unrealistic job description. I am a general practitioner, a surgeon, a dermatologist, an ophthalmologist, a therapist, etc. “Incorporating personal wellness practices into curriculum” is a great idea for any profession, but it will not begin to address the problems that can lead to depression and suicide. — BethAnn Palermo, DVM, Sonoma, Calif. Should Society Bare Bigger School Cost? In the April 2016 issue of Veterinary Practice News is yet another article about the growing problem of veterinary graduates’ student debt [“New vets smothered in debt”]. The article stated that the average debt after graduation from veterinary college is $174,000, with some over $300,000. I graduated back in 1971, when tuition per year was a manageable $1,000. It seems to me that today’s higher costs exceed the rate of inflation by a huge margin. I often wonder why tuition was priced so reasonably in 1971. Was it because our society placed a higher value on producing veterinarians? Why might that not be the case now? Is it because of the changing social values and politics? We are seeing backlash in the presidential campaign from one candidate’s suggestion that college education be free. I am not suggesting that it be free, but it certainly should be far more affordable for the average veterinary student. Society must begin to set priorities on how we best spend our tax dollars, and we must decide if the greater common good means that some more well-to-do citizens might need to pay more in taxes. If society values having a good pool of highly trained veterinarians, then that should be the cost society should bare. This premise, of course, applies to a whole host of social problems. Having a good pool of qualified and dedicated veterinarians should not only come from students who can afford to go to veterinary school. By pricing some lower-income students out of our profession, we may be eliminating some from even considering becoming veterinarians; individuals who could be exceptional veterinarians. Suggesting that those who cannot afford veterinary education receive reduced tuition by either military service or practicing in rural areas ignores the social costs of providing these benefits to veterinary students. There are costs. What we need in this country is some serious discussion on what public expenditures best serve our country’s needs. We hear little discussion of this in the political discourse of the day. What we hear most often are the admonitions of the increasing tax burdens. If this country sets its priorities for the benefit of all of society, we might find that we do not need to increase taxes. We might find that we have the dollars but must spend them more wisely. — Bill Habedank, DVM, Red Wing, Minn. Math Problem Thank you for printing the article about Dr. Ron DeHaven’s decision to retire in August [“Q&A: Ron DeHaven, AVMA’s departing CEO,” March 2016]. In discussing starting veterinary salaries, Dr. DeHaven stated that “if we can increase starting salaries by just $2,000, that enables a student to service $50,000 more in debt.” That is incorrect. A $50,000 student loan for 20 years at 6 percent would require more than $6,100 to cover it. Even a zero-interest loan for 30 years would require $2,400 additional gross pay. — Philip D. McHugh, DVM, Durham, N.C. Dr. McHugh is a past president of the North Carolina Veterinary Medical Association. Becker’s Admission Hurt All Veterinarians To use Dr. Marty Becker’s words [“I lied when a pet died,” February 2016]: Sickening. Unfathomable. Unforgivable. While apropos, hardly adequate. Not only did he kill this poor dog, he then manufactured artificial tears for the owner and casually discarded the carcass to the rendering pile instead of the respectful burial he had promised the owner. Well, the statute of limitations has expired, the hospital has burned down with all records of the event, and he has “found God,” so why not confess and clear his conscience when he has nothing to lose? Except that he threw the rest of the profession under the bus so he could feel good about himself. I feel sorry for those veterinarians who will, or have, lost a patient through no fault of their own. For those clients who have read this, a jaundiced eye will be directed their way and blame will be laid when none is due. For someone professing to be “America’s veterinarian” and constantly spewing off about how we have to make the clients part of our practice family and make our practices “Fear Free,” he has done irreparable harm to the rest of us who still are practicing every day, not just when our busy schedules allow. This episode has hit social media now, and I already have had clients ask me, “What’s wrong with him?” God only knows! Maybe God will forgive him. I won’t. — William Radovich, DVM, Costa Mesa, Calif. The Emergency Vet In the middle of the night when everyone else is asleep, when the rest of us are out of town or on holiday, an emergency veterinarian and his or her staff are the brave souls who stay alert, ready to handle the next crisis. They wait, prepared for a patient who is bleeding, having a seizure, unconscious or screaming—the patient that can’t wait until normal business hours. In short, emergency doctors and their staff are heroes. Regular 9-to-5 veterinarians have the right to restrict their practice any way they want to—small or large animals, cats, birds, horses, surgery only, whatever the practice owner decides suits him or her. Not so with an emergency veterinarian. Why? Because it’s an emergency. We all solemnly swore an oath vowing we would dedicate ourselves to the protection of animal health and welfare, and to the prevention and relief of animal suffering. So when a veterinarian is presented with a suffering patient and there is no one else better qualified available, we must step forward and do what we can, regardless of whether we feel comfortable with that particular species. What if a vet is unfamiliar with a certain type of patient? In days gone by that meant he franticly called anyone he could think of who might know more than he did for advice, or he did the best he could working in the dark. But in today’s Information Age, it takes less than 30 seconds to find out if you can give Clavamox to a sugar glider. The oath we swore also says: “I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.” So there is absolutely no excuse for an emergency veterinarian to chicken out. So why am I writing this letter? Because more and more my patients are being turned away from emergency clinics. One frantic client was 75 miles away from me and called every emergency clinic between her and me as she sped toward my clinic. They all turned her down, some saying they were “uncomfortable” treating a ferret. The patient died before she could get to me. Yes, they all should have known it is perfectly legal for a veterinarian to treat a ferret in California. Two nights ago, our local emergency clinics turned away a 15-pound miniature pig that was bleeding from a bite wound from the family dog. It’s not as if these hospitals were being asked to treat a king cobra or a wild boar. This sweet little pig fit into a cat carrier and could be carried in one hand. He allowed me to clean, prep and suture the wound without anesthesia—a good thing since I am a general practitioner and, therefore, I do not have technicians ready to assist me on a Sunday morning. Heroes don’t get to pick and choose. When the bat signal lights up the sky, Batman puts on his bat cape and comes to the rescue. He doesn’t say, “Sorry, mayor, I’m not comfortable with penguins, you’re on your own.” Any veterinarian who has graduated from veterinary medical school can do basic stop the bleeding, stop the seizure, stitch the laceration and stabilize the patient-type care until a patient can be transferred to its regular veterinarian. And any emergency veterinarian with a fully operational hospital—lights on, machines up and running, staff ready and waiting—who would turn away a seizing or bleeding or unconscious patient should be ashamed to call themselves an emergency doctor. Because emergency doctors and their staff are heroes, and heroes step up to the plate. Jona Sun Jordan, DVM, Santa Rosa, Calif. Refreshing Viewpoint I would like to offer a different perspective on the Evidence-based Medicine columns by Dr. Narda Robinson after having read the negative opinion expressed in the letter “Evidence columns keep falling short” [March 2016]. Dr. Robinson’s column is the primary reason I subscribe to Veterinary Practice News, and it is always the first thing I read when I pick it up. As a conventional practitioner who also utilizes acupuncture and herbal therapy in treating my patients, I find Dr. Robinson’s perspective to be refreshing compared to the archaic paradigms and pseudoscience that often is used to explain these modalities. She presents her topics in a scientific and factual manner, and employs a degree of analysis and integrative complexity that I find enlightening. I do not know Dr. Robinson, but I greatly appreciate her contribution to our profession, and I hope that she continues to write her column in your publication for many years to come. Steve Gardner, DVM, Dipl. ABVP, Berkeley, Calif. Educational Evidence Perhaps Dr. Dawn Ziegler doesn’t understand the accepted manner in which to engage in a discussion of evidence-based medicine. If Dr. Narda Robinson is falling short of her expectations, she needs to counter Dr. Robinson’s “negative” information with positive “evidence,” if it exists. How can someone demand an end to an informative column, claiming Dr. Robinson doesn’t know what she is talking about without any proof to that effect? The apparent intent of the column wouldn’t appear to be a holistic one. Instead it’s to educate those who rely on evidence-based medicine but are interested to see what useful information might be integrated into their practices. It also demonstrates to holistic practitioners where real evidence is lacking in their beliefs or assumptions. If it isn’t of benefit to you and you can’t counter it with evidence, an alternative is to not read the column. James C. Frank, DVM, Milwaukee, Wis. WHAT DO YOU think? Letters to the editor on anything published in Veterinary Practice News or on any other veterinary topic may be emailed to Ken Niedziela at kniedziela@luminamedia.com or mailed to Ken Niedziela, Veterinary Practice News, 2030 Main St., Suite 1400, Irvine, CA 92614.
