Not that I’m the poster child for veterinary practice … nor am I even remotely in the running for clinician of the year. I have too many bad habits, ingrained biases and pent-up resentments. I commit far too many set-in-my-ways sins and give in to more than my share of slothful indulgences to preach from any pulpit. So much so that “Do As I Say, Not As I Do” might as well be the headline for this month’s column. With last month’s column dissing physicians fresh in our heads, I’m here to tell you there’s a whole lot more we could be doing to improve the quality of our results. That’s something we can all get behind, right? Trouble is, we’ve all got our own ideas of what’s sinful and what’s not. Which is why I make no apologies for my list. Here’s my current list (you never know, it may change next week): 1) NOT Speaking Our Minds For Fear Of Client Retribution Do you tell clients they’re killing their pets with all that food they insist on feeding? That their puppies hail from less-than-reputable sources? Their dog needs to wear a muzzle at all times before you’ll deign to see her again? The retractable leash they’re [mis-]using is verboten in the hospital from now on? Do you refuse to give half-dose vaccines when they demand a “safer” approach? Explain that a tail dock at 6-months-old is absolutely unnecessary? Decry the use of a prong collar on their pug? … Or do you look the other way instead of calling clients out on their gratuitous requests, outright ignorance and otherwise questionable behavior? If we don’t step out of our comfort zone to enlighten our clients, who will? 2) NOT Addressing Our Patient's Stress I’ve done enough relief work (thankfully, in the past) to know that patients behave very differently at different hospitals. It didn’t take much of this detail before it became clear that pets are simply more stressed out at some hospitals than at others. And it’s not because the patient populations are inherently different. No, it’s not enough to have a good attitude around our patients. Basic practices, policies and procedures can be altered to improve patient comfort and client compliance. Though Dr. Marty Becker and board-certified behaviorist Dr. Sophia Yin (among others) are working hard at disseminating information on the feline side of the equation, there’s a lot of heavy lifting to be done yet. In case you haven’t heard, Dr. Becker is forming a coalition of the willing and the educated to help broadcast the message. Meanwhile, Dr. Yin, also on Dr. Becker’s team, is offering a certification program that addresses low-stress feline handling techniques. 3) NOT Employing Checklists If there’s any one thing you should be doing to improve your practice, it should include the humblest of tools: the checklist. The U.S. Air Force was first to employ these, decades ago, to help pilots master mind-numbingly complex machinery—without missing a beat. And now that our work involves the implementation of a variety of highly technical tasks that are equally taxing, if routine, we need these checklists every bit as much. Though we may argue that medicine should never succumb to a cookie-cutter mentality, quarrelling with the checklist is like disputing the services of a surgical drill. One is simply more expensive, harder to use, and makes us look like we’re worth every penny (even when we’re not). The other is far less sexy but clearly of more far-reaching benefits. The Checklist Manifesto, authored by celebrated writer and surgeon Atul Gawande, spells out just how crucial checklists can be for anyone in a highly technical field. Whether you never want to miss another talking point on a well-puppy visit, forget a step in your standard presurgical plan, or overlook an item on a blocked cat’s estimate, this approach is for you. Of course, it’s a no-brainer teaching tool for staff, too. 4) NOT Taking A Patient-Centered Approach To Our Work I spent most of Easter weekend in and out of the hospital after a friend took seriously ill. Which, of course, meant I’d be observing things closely in the hopes of learning a few new tricks or (at the very least) collecting some fodder for my upcoming columns. And, of course, I found some. Right next to the door of the ICU (you couldn’t miss it), I spied a list of “10 commandments” directed at hospital staff members. Unfortunately, not a one mentioned anything about patients or patient care. These words were conspicuously absent. Speaks volumes, don’t it? 5) Discounting Our profession’s “Red-Headed Stepchildren” Not all subjects are sexy. It’s just not possible. But where would we be if we didn’t practice dentistry, for example? To be sure, our patients would suffer, to say nothing of our income. In fact, by my estimation, I’d have made 15 percent less last year if I had ignored my patients’ teeth altogether. What’s even more interesting is that the majority of this income comes not from routine procedures, but from the more complex procedures we undertake. Investing in our profession’s red-headed stepchildren clearly pays off. 6) Failing To Offer Our Clients Effective Financial Solutions It’s not good enough to give it away occasionally, or even routinely. As veterinarians we have a duty to help our communities build better systems for managing pets of the indigent and destitute. This means we should be promoting pet insurance, carrying CareCredit and the like and writing off our good deeds wherever possible. Ours is a business, and we shouldn’t be in the habit of ignoring that fundamental fact. But it’s not just the impoverished we should be worrying about. While I count few of my clients among the ranks of the truly poor, most of my clients can benefit from financial products to help mitigate their risk in the event of a big vet bill. Indeed, even the littler vet bills become easier to take (and my fees way less stressed over) when my clients have purchased pet health insurance. This truism holds, regardless of income. 7) NOT Acknowledging What We Don’t Know This one is a perennial item on my list of seven deadly veterinary sins. In fact, it’s perhaps the deadliest. NOT acknowledging what we don’t know speaks equally about humility, honesty and professionalism: Humility, because we’re unwilling to look at ourselves critically. Honesty, because when we aren’t aware of our own failings, we’re not being honest with ourselves and, in turn, we can’t be honest with our clients. Professionalism, because it all trickles down to how our patients are treated. They suffer when we insist on practicing medicine in a vacuum. ’Fess up, we all do it in some ways. So that’s my list. Message me on Facebook at www.facebook.com/pattykhulyvmd, on Twitter at www.twitter.com/drpattykhuly, or on my blog at www.drpattykhuly.com if you’ve got any more sins you want to disclose, anonymously or otherwise.
