Wednesday, April 2, 2014

Are Aussie vets old school?

Pets have moved from the backyard to the bedroom...some blend in seamlessly!
As someone with a strong interest in the human animal bond, both personally and professionally (I lecture about this at Sydney University), I was stunned to read the following statement in an article in The Australian by Tim Boreham (read the full article here):

Veterinary entrepreneur Glen Richards reckons that most of the country’s 9000 vets “don’t appreciate the dog has gone from the backyard to the bedroom’’ — a reference to the increasingly rarefied position of our furry friends on the social stratum.
This means a profound shift in the expectations of their owners, who are willing to pay for more complex procedures to salve the wounds of their creatures great and small.
“I reckon half the industry is practising as if it were the 1970s and 1980s,’’ says the 49-year-old co-founder of the listed vet consolidator Greencross — and the proud owner of a Bernese mountain dog, a Maltese terrier, two Devon rex cats and five horses.
Them's strong words. Is it true that 4500 vets in this country are really ye olde school? What does it mean? Here are my thoughts.

[I'm going to go out on a limb here, as I graduated in the mid-noughties and did not practice in this era, but I'd talked to many vets over the years who did].

Well, in the 1970s and 80s most animals had a much more limited lifespan. Poor animal control, the absence of leash laws and microchipping meant that most pets were passively acquired, as strays, many suffered major trauma on roads, and an absence of flea control meant that the "flea bags" were, on the whole, relegated permanently to the outdoors. Digital x-rays, pulse oximetry, radioactive iodine, advanced imaging - these are relatively new.

Back in ye olde days, if an animal had a terminal illness, very few options were available - the treatment for cancer was often euthanasia. There were few drugs to choose from. And pain relief? Well, non-steroidal anti-inflammatory drugs for animals were registered in the 1990s! (And post-operative pain was considered by a very few old skool vets as a handy way to ensure animals kept quiet after surgery). Anaesthetics were archaic, continuing education was something people did to score a skiing holiday in Aspen (veterinary boards only started mandating on this in the noughties). 

We've moved on big time and I would have to reject the claim that half the vets in the country have not. I suspect that Glen Richards would also heavily qualify his statement if challenged. What I think he means is that the standard of care we can provide is much higher, and that pet owners expect that high standard - but perhaps too often, some vets (surely not half) provide less than the gold standard. 

Having visited veterinary clinics in numerous other countries, and around Australia, I am confident in saying that the standard of veterinary care provided here is generally excellent. There are the odd exceptions to the rule, but they hardly constitute 50 per cent of the profession!

And...and here I go out on another limb...not everyone wants the gold standard. For various reasons. Money is one. But we also have to take the animal into account. For example, when my late cat Lil became ill, we had to factor her goes-feral-every-time-a-vet-approaches attitude into the treatment plan. And the ability of the owner to deliver treatment (if your cat punctures your arm with her canine teeth everytime you try to administer a pill, that's a strong disincentive to medicate the cat). Not every owner is able to administer an insulin injection twice a day to a diabetic patient.

As a vet I want to deliver the best possible care to every patient, but sometimes the "gold standard" isn't the best for that patient, outcomes for treatment are never guaranteed, and providing options to clients is vital. Someone can be closely bonded to their cat, but that doesn't mean they can afford potentially curative brain surgery to remove a meningioma. That's something we have to live with and work around. 

Best practice is about delivering appropriate, where possible evidenced-based care, to the patient in front of you - taking into account various contextual limitations. And the profession takes this seriously. This year the Australian Vet Association's conference is themed around the question "What's best practice?".

And...even though we have excellent parasite control and high-profile media vets sipping cappucinos with their pooches in the eye of the public, not every pet has made the literal move from backyard to bedroom. The social status of animals remains controversial and hotly contested. The values of our clients are heterogenous.

Are Aussie vets really old school or in denial about the human animal bond?

3 comments:

  1. Bit of furore over on Facebook AVA page about this too.
    I've copied and pasted part of a comment - it's a bit long so I had to edit . P.S. It's not mine

    We could argue that in an "evidence based profession" the Greencross system is a proven method. But at what cost? When corporations establish a "dominant and defendable market leading position" what happens to the living? Instead of the machine functioning for the improved health and welfare of animals you end up with a machine that recommends animals and health care systems that feed its purpose.
    You can run a highly successful practice without corporate ownership. You can develop skills and get support without being a minority shareholder.
    People are individual and unique, so are their pets, performance animals and even their production herds.It is the diversity of life that draws our curiosity and desire to work in this profession.
    If you want to express your personality and opinion in practice and effect change to the benefit of animals nationwide, then consider your position on corporations carefully. Veterinarians work as independent thinkers so we can be advocates for animals, regardless of the social age we live in. And if Greencross buys out every established practice it will dramatically change our capacity to be those advocates.

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  2. Hmm, I have to say, as a qualified dog trainer who is religious about CPD and keeping up with best practice, I hear (usually second hand) some very bad advice that vets have given their clients about behaviour and usually punishment, so I have to say that yes, there are some "old skool" vets out there. I think there is a difference between metropolitan graduates and regional graduates, sorry, just putting it out there

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  3. It is a shame when a professional uses an unsubstantiated opinion to insult his colleagues to make himself look better. But it is in keeping with his belief that the veterinary businesses that aren't owned by his corporation are in disarray too. I don't agree with either of his positions.

    I know veterinarians are amazing, caring, sensitive and hardworking whether working in independent or corporate practices, and that each of us provide such an essential service for our community.

    See, it isn't hard to rejoice what we are as a special group of people. Why can't we all work cooperatively towards improving our pet's well being, rather than slinging insults.

    I would argue that the majority of independent veterinary hospitals treasure and build the relationship between themselves and their loving pet owners based on mutual trust, and make an effort to ensure continuity of care.

    I know of many independent veterinary hospitals who provide exceptional care and facilities for their pets, and obviously, only do so because of their love of animals, and respect of the relationship between owners and their pets.

    I am proud to be one of the many quality independently owned successful veterinary businesses in Australia, and see nothing wrong with the small business model of practice.

    I suspect Greencross is actually jealous of the small business model, and is threatened by it, as I can think of no other reason of insulting us "old skool" vets in small business.






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