5 Lessons Medical Practitioners Can Learn From Veterinarians
When little things become big issues
My red heeler, Chilli, recently came off second best in a rumble with my staffy cross, Rotto. An ordinary trip to the vet triggers deep anxiety within Chilli. She is, even on her best days, a nightmare of a patient. She’s the type of dog that makes trainee veterinarians second-guess their career choice.
An emergency vet trip, combined with pain and significant blood loss, saw Chilli morph into a whirlpool of emotions and gnashing teeth. With thirty kilos of agitated dog twirling around spraying blood, it looked like Stephen King had taken over and blended Carrie with Cujo.
Nonplussed, the staff did everything possible to make Chilli feel safe so they could stop the bleeding. It’s the same at my regular vet clinic. Everything is designed around making the patient feel comfortable and at ease.
Why don’t medical practitioners work to the same method? And what can they learn from veterinarians?
1. The patient should always be number one
Living with Cystic Fibrosis and a compromised immune system due to a lung transplant, I am at an extremely high risk of contracting an airborne respiratory virus. (I’m not just pointing the finger at you, COVID-19).
In 2012, my lung function was compromised. It was my first major infection since I’d traded in my manky old lungs. My donated lungs needed a little medical intervention to help them do their job. An orderly collected me from the respiratory ward, and, on arrival at x-ray, he parked my wheelchair next to a yellow carded patient. In the Western Australian hospital system, a yellow carded patient means they have an airborne respiratory illness.
You don’t need a medical degree to join the dots and figure out this was a less than ideal place for me to sit. My polite request to be moved was just as politely ignored. I learned to navigate the hospital system at an early age. There was only one advocate that had my back.
Me.
My performance was worthy of an Oscar.
As there was nowhere else to ‘park,’ I ended up sitting tucked in an alcove out of sight. I’m pretty sure the staff made me wait longer because I’d morphed into a germophobic nightmare for them. Still, it was a safer option than sitting next to a yellow carded patient. (Thank you, COVID-19, for educating people on the hows and whys of airborne contagions, so I no longer have to seem like a germaphobe.)
In contrast to the Australian public health system, my vet clinic has four consulting rooms with only two vets on shift. That leaves two rooms for nervous or aggressive dogs to wait separately.
Chilli’s patient file has a permanent note attached about her anxiety. It may even have a note about her germophobic owner — but that doesn’t matter because Chilli is treated better than the Queen’s corgis on arrival at the clinic.
We’ve been frequent flyers lately due to multiple pressure bandage changes. And we’ve gotten into a bit of a routine. Chilli and I sit in our own private room. The vet enters quietly, speaks in a soothing voice, squats down at Chilli’s level, and pets her.
After the administration of Chilli’s sedation, the lights are turned off, and we’d be once again left alone. When Chilli succumbed and finally nodded off into her twilight sleep, the vet would return. The door was always left open, and the vet would change her bandages in the dim light as both light and loud noises can ‘wake’ a sedated dog.
As the patient, Chilli is always the number one priority in the room.
2. Health is a service industry, but no one has informed medical staff
My transplant team includes three consultants. Leaders in the field of respiratory medicine. However, because my hospital is a teaching hospital, doctors regularly rotate through the Advance Lung Disease Clinic. Minions. They’re there as part of their training to learn about various medical disciplines.
Often the minions are ticking a box to finish their studies or as an entry requirement into another discipline. A consult with a minion is like ticking boxes, too — you never want to bring up the big stuff because they can’t make decisions. Instead, they need to go and consult their Leader.
In the raffle lottery of patients' files, a minion plucked mine from the stack of medical tomes. As he gazed across the clinic, the number of people sitting like herded cattle in the waiting room caused the minion some concern. He glanced at his watch and frowned. Consequently, he rushed through my consultation.
At the end, when I presented him with a list of medications I needed new scripts for, he brushed me off. “I don’t possibly have time to call for an authorization number for these scripts. Haven’t you seen the waiting room? I’ll do it this afternoon and post it to you.” Without leaving me time to answer, he strode out and called his next victim in.
Back in the waiting room, I promptly rang the minion’s Leader and turned on my Oscar-worthy charm. The cocktail of pills I pop is finely tuned and causes chain reactions, as they link hands and dance throughout my body. When one link crumbles, the risk is akin to a tumble in the middle of the Dirty Dancing lift.
With one weak link, it was critical to refill that medication urgently. A situation that a simple question could have avoided. “Are there any medications on this list you need urgently?”
Goodwill is the single reason I’ve used my vet practice for the last 29 years. I’ve moved house many times, and there are several closer options. All have a solid reputation. Yet, I return to the same practice because the service is always outstanding.
But the possibility always remains that if I become unhappy, I might choose to jump ship. Goodwill is a huge part of any business, and all the staff at the vet practice factor this into all their client transactions.
Their service is not only outstanding at the time of the visit but also in the follow-up. Whenever one of my dogs has been for a procedure, the following day always brings a text or phone call asking after my dogs’ welfare.
Vets stop to talk to their patients, soothe them, and take the time to pet them before they start examinations. It’s all too easy for a frightened animal to turn aggressive. Animals are unpredictable and can snap quickly.
Vets treat the patient, not the waiting room.
3. Treatment methods are presented as options
“If you don’t start taking your blood pressure seriously, you’re going to die.”
It was said in the I am a doctor and I know what I am talking about voice. The one doctors with a god complex always use. It’s usually annoying. But from a minion, it’s insulting.
Ultimately, it was a tactic designed to scare me into compliance. I was supposed to act like a good girl and take the medication without asking questions.
However, the minion with his god complex failed to consider that I’d been to all the previous meetings about my blood pressure issues. I was well versed in my own history. I’d been through the dress rehearsal already. This blood pressure medication had already failed to dance nicely with others. It turned my finely tuned waltz into the jitterbug. The issue wasn’t as simple as popping that particular pill.
I didn’t need a lecture. I needed a workable option. The minion went to consult his Leader and came back with a new, improved plan. Eventually, after a few mishaps with the cha-cha-cha, I played with the timing of my medications. There was a period of moonwalking before I finally solved the interaction issues and got my waltz back on track. There was, however, no point when I wasn't taking it ‘seriously.’
There is no good way to deliver bad news. In 2018 my blue heeler, Pepsi, was diagnosed with canine cancer. My husband and I were given multiple options—the pros and cons of each option carefully presented to help us make the best decision.
- Surgical removal of the tumor. Possibly followed by radiation.
- Doggy chemotherapy.
- Commence palliative care and keep Pepsi’s pain under control.
Ultimately the decision was ours. My husband and I chose palliative care and gave Pepsi a bucket list (okay, that was mainly me — but who’s to say dogs don't dream about bucket lists … ice-cream in the park, the whole pizza, not just the crust …).
At no point did anyone at the vet practice attempt to talk us into another option. It was never about money. The issue was always about what would be best for Pepsi.
We knew what was best for our dog, and our vets respected our decision.
4. End of life options
The euthanasia debate will always be controversial. But until you are in that position, you have no idea what you will want or if your fixed mindset views will change.
Here’s what I do know. I was mere weeks away from dying when an offer of donated lungs saved my life. Dying from respiratory failure is a slow, brutal way to die. It is not a waltz that leads you off into the sunset with slowly fading music. It is the most degrading thing I’ve ever endured. There is no dignity when you are slowly dying.
I lived through that experience because I had hope. I had faith in my fellow humans that an offer of donated lungs would come. I did everything I could to stay alive long enough to get that phone call.
In the end, I was hanging on by my fingernails. Sheer willpower alone kept me breathing.
Next time around, when these wonderful lungs eventually fail me, there will be no lifeline. There will be no hope. There will be no phone call. At the end of the pain, the indignity, the loss of everything I hold dear, I will die.
I may want an out. At a time and place of my choosing. To let the waltz fade into the sunset after all.
Legislation in Australia is slowly evolving. And I may get that out. But it needs to be my choice to make.
One Friday, our bouncing girl ran through the house demanding her breakfast. But in the afternoon, Pepsi’s tumor grew the tiniest bit larger, and it pushed a little harder against her brain. Without warning, we became unable to control Pepsi’s pain. With a single look, my husband and I knew that the next day would be her last. We gave her the highest dose of pain relief available to help her sleep.
Keeping Pepsi alive at that point would have been for our benefit — not hers.
On Saturday morning, Pepsi had pancakes for breakfast. My husband cooked a Jamie Oliver recipe for lunch, and outside the vets, she had her final bucket list treat. White chocolate — a treat she’s always wanted to try.
No one at the vets second-guessed our decision. No one tried to talk us out of ending Pepsi’s life.
Instead, they treated her with dignity as she took her last breath.
5. Yes, please to the tasty treats
I’ve seen TV shows where pediatricians give patients a lollipop at the end of the consult. The Friends episode where Ross bounds out after his appointment with his pediatrician is one that immediately springs to mind.
But I’ve never once had a doctor offer me a lollipop. Instead, I’ve been given scripts for fistfuls of medications, sample pots for me to provide specimens, x-ray forms, or instructions for procedures they wish me to undertake.
Just once, it would be nice to get a tasty treat like my dogs do when they visit the vet.
A tasty treat often makes everything better.
Of course, there is one habit I don’t want my medical practitioners to pick up from veterinarians.
At all costs, keep that thermometer away from my butt!