A new mandate in California makes important points. Putting aside the details of the case that led to the law ( the death of a dog in an attempt to improve her health) the issues that pop into my head include:
1. Information sharing should always be standard of care. I try my best without being overwhelming but there are so many liabilities! Case and point: tv drug commercials spend more time on disclaimers than any other content. How many owners will absorb all this info and hold themselves responsible if they don't follow the directions on both administration and patient care ? Sometimes I get told point blank "Doc, I don't want to know." That's hard.
2. How many people will actually read the 4-6 pages of drug notes that we will staple to the medication? Is that enough? It seems to be in human medicine. At least to cover legalities.
3. The public is demanding that veterinary medicine be brought up to par with human medicine: Yay! But, are society and individuals ready with the costs of vet medicine joining the ranks human medicine? Pet parents aren't just paying for the value of a vet's knowledge, their time, treatments and procedures. Costs have to include everything that architects the capability of vets existing to help pets ( facilities, office supplies, business expenses, insurances, licensing, support staff, device, maintenance, continuing education, inventory, etc) Get on board with pet insurance. No Obamacare....uh, Bo&Sunnycare, for pets, yet.
4. DVMs/VMDs/BVsc want to be as respected as their MD counterparts given that they have the same education (prior to specialization). Do our practice habits (and guilt) prepare us for the increased financial and time costs and having to pass these costs on to our clients? Where does our profession stand on the return on financial, physical and emotional investment ?
The most important point is that vets and pet owners need to have clear communication: tell vets what symptoms your pet has, tell them about your gut feeling, tell them about your financial, emotional, time, and physical budget. Don't withhold information because you are afraid vets are going to recommend more testing or expensive medication. Both sides need ALL the information before an informed recommendation or decision can take place. Recommendations are not marching orders. They are recommendations, and they have their hierarchy of importance. The bottom line is there are always options ( some which my be less favorable than others, but remember the goal: to relief pain and suffering- see the Five Freedoms blog entry for December 2017). You are a team. All voices matter.
Take responsibility for the things you can, can't, will or won't do for your pets. It's ok- everyone has their point of view and limits, vets included. Ask questions, and let your vet know what type of communication you need.
When things don't turn out right in our mind, our emotional cycle often starts with fear, anger, and blame. That can set precedence for complete breakdown of communication and civil resolution if the parties involved refuse to take a step back to accept mediation and understand the most realistic remediation. Malicious intent and purposeful neglect is rare in our profession. Veterinarians are human, just like everyone else. We often lead with our hearts, for better or worse.
The most important concept is to understand that we all have limited control over biology and being alive is a risky thing by nature. Be a team together. Medicine is the marriage of science and the intuitive art of wooing nature, not controlling it.
Adventurously spirited. Grammatically Dubious. Enthusiastically Sincere.