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Dr Charles Kuntz, from Southpaws Specialty Surgery for Animals, in the office. |
Can you tell us about your day job?
I am a specialist veterinary surgeon. I
try to improve the quality of life in pets and their owners when they present
to me with serious (generally surgical) conditions. I have been a specialist
veterinary surgeon for 18 years. I started and currently run a “boutique”
veterinary referral practice which is growing by the day. My responsibilities
are clinical, teaching, marketing and management. I love what I do and can’t
imagine doing anything else.
What kinds of surgeries do you perform now and why are they challenging?
I perform nearly any kind of veterinary surgery. Really the only thing I don’t
personally do is joint replacement. I leave that to my business partner and
associate Dr. James Simcock. I do a lot of cancer surgery which means removal
of large tumours. I have sub specialist training in surgical oncology and am an
ACVS Founding Fellow in Surgical Oncology.
I also really enjoy neurosurgery.
This includes removal of brain tumours, decompression of the spinal cord
due to disc ruptures, decompression of nerve roots due to lumbosacral disease
(which is like sciatica in people) and correction of congenital brain
abnormalities. I find neurosurgery particularly enjoyable because it is very
technical and requires a lot of concentration. Also, the results are usually
great which is rewarding.
I do a lot of orthopaedic surgery for ligament
injuries in the shoulder and knee. I also do surgery for developmental diseases
of elbows and hips. We don’t do much trauma surgery because of the good leash
laws in Australia.
I also really enjoy soft tissue surgery for urinary tract,
respiratory and intestinal problems. Again, they are fairly technical and require
a good knowledge of anatomy. If I could design my perfect surgery day, it would
include a brain tumour removal, a lung tumour removal, a disc rupture, a
shoulder ligament replacement and an adrenal tumour removal. [Ed: My perfect surgery day would be WATCHING that!]
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Dr Kuntz: good trainers keep training. |
I was
pretty good at surgery in veterinary school. I always found the technical part
of surgery pretty straight-forward. The challenge for me has been learning the
perioperative care - learning when to cut, how to minimise suffering before and
after surgery and how to maximise the outcomes with good patient care.
I have
always done stuff with my hands. Early on, aged 10-14 it was taking apart
radios and things, 18+ it was playing guitar and I have always enjoyed woodworking
although I have been banned by my wife due to a stupid and pretty serious
injury which occurred about 18 months ago. I was using a very sharp chisel and
cut three tendons, two nerves, two muscles and an artery in my left hand. I had
three hours of microsurgery and was operating again (against doctor’s orders)
48 hours later. I was what was called a “very motivated patient” with respect
to physiotherapy and have had an excellent recovery with no residual
deficits.
How does
someone become an expert in surgery?
The most effective way to become an expert
in surgery is to do an internship, surgical residency and specialisation. A
residency is a 4-5 year program which involves extensive training, supervision
and examination under the guidance of other established surgical specialists.
During my residency, I experienced long hours and performed about 1,000
surgeries.
I read thousands of articles and about a dozen surgical textbooks,
on which I had intensive examination. I also did a Master’s degree at the same
time and published several articles. Even with all that training, I was most
certainly not an expert when I was finished (although I thought I was). In the
18 years since the completion of my specialisation, I have continued to learn
actively every day by observing other surgeons on youtube and in human
hospitals, intensively reading the literature, continuing to publish and
developing new techniques.
One of the best things I have done to develop my
skill has been supervising surgical residents. I have mentored two residents
through their programs from veterinary school all the way through
specialisation and currently have two more in different stages of their
programs. Having residents around forces me to be consistent and honest in my
approach to surgery. It also forces me to keep up with the relevant veterinary
literature and to justify my decisions.
That being said, I know of lots of
great surgeons who have not done surgical residencies. It is much more
difficult because the training has to be more self-directed and self-motivated.
Resources can be hard to find and it can be challenging to go home and read for
three hours after a big day in the clinic if no one is forcing you to do it.
Continuing education is great in the form of attending lectures and reading
articles and textbooks. Also, one must be completely honest with one’s self
about successes and failures in order to improve. I had a mentor who said that
no matter how well a surgery went, you should be able to pick three things you
could have done better. You should never settle for “good enough.”
Why is it important to do things differently when you can?
It is always
important to constantly question what you are doing and to never settle for
status quo. I am always challenging myself to improve my technique. I never
accept that the current way of doing something is necessarily the best way. I
try to keep up with the veterinary literature and always question if there
might be a better way.
What
continuing education/training do you do?
The most rewarding continuing education
I do is training surgical residents. I have been really lucky with the
residents I currently have in that they are really hard-working, clever and
technically gifted. They are also really great people to be around. We always
have a laugh at work. I also try to foster an atmosphere where they can
challenge me and are welcome to question my decision making. They do not accept
“Because that is the way we have always done it” as an answer.
We also have
interns which are graduate veterinarians who are hoping to specialise in some
discipline. They are usually with us for a year. We have been really lucky in
getting our interns placed in residency programs. I am an academic associate
with several veterinary schools and frequently have veterinary students at our
practice. It is really exciting to have these young and enthusiastic people
around who are looking for guidance in their careers. I especially enjoy
recognising that “spark” in a few of our students that suggests that they are
going to be the leaders in veterinary medicine in the future.
I lecture
frequently locally, nationally and internationally and find this aspect of
continuing education enjoyable. I try to make my lectures practical and fun,
and try to inspire people to be the best vets that they can be. I also do
newsletters monthly which are both educational and provide marketing for our
practice. I also do continuing education every day with our referring vets. I
try to make cases a learning experience for them in hopes that they can carry
some of the information that they learn from the case at hand onto their future
patients.
I also actively teach nurses and encourage them to ask me questions
in surgery and in the treatment room. It is important that they understand the
decisions we make. Again, “Because that is the way we have always done it” is
not an acceptable answer to their questions. I have a very active youtube
channel with around 90 videos. We have had around 200,000 views from 183
countries. It is rewarding to me to have vets in developing countries watching
and learning from our videos in an attempt to provide options for their clients
when referral is not an available.
You
recently incorporated a 3D printer intp your practice – how do you use it?
I
love technology. I incorporate new technology into my practice any way I can.
One of our latest acquisitions has been a very high-quality 3d printer which
was partially supported by a grant from Royal Canin. With it, we can easily
print plastic bones of patients which have been scanned on our CT scanner. We
can use these bones to practice a surgical procedure (like fracture repair,
tumour removal or repair of a congenital bone abnormality) on a patient prior
to the actual surgery, pre-contour plates, better explain a disease to clients
and referring vets and use as a marketing tool.
What
resources can you point readers to?
Veterinary
Information Network is a great resource for vets who may feel isolated in
private practice. It is a subscription-based service which allows searching of
forums on discussions in numerous different fields (like neurology, orthopaedic
surgery and soft tissue surgery). If you are feeling brave you can post your
own questions and have several responses within 24 hours from experts in the
field. There are also proceedings from conferences and access to abstracts from
veterinary publications.
We have the SouthpawsVet youtube channel which has
around 90 videos of different surgical procedures [Ed: I am watching these as soon as I get home from AVA!]. There are also thousands of
human surgical videos on youtube which may provide some ideas for treatment
options. Specialists are also a great resource because we are expected to keep
up with our area of expertise.
We welcome questions from primary care vets
whether they are about potential referrals or about general knowledge. I also
read medical history books and biographies because they inspire me to advance
my abilities and sometimes give me ideas on how I can better treat my patients.
Are there
any non-humans in your life and what have they taught you?
We have two very
silly male black Labradors. They live for the moment, love unconditionally, are
not embarrassed about being really excited and are extremely loyal. They don’t
stress about the future and don’t seem to worry about the past. I really admire
those qualities about them.
Thank you Dr Kuntz for taking time out of your schedule! We're truly inspired.
Thank you Dr Kuntz for taking time out of your schedule! We're truly inspired.