A conversation with an administrator at a local animal shelter the other day reminded me just how un-progressive veterinary medicine is here on Long Island.  First, a little background information: A couple of years ago, I agreed to perform some spays and neuters for the town shelter at a reduced rate.  Basically, we were doing them for free.  Our monetary compensation for these surgeries barely covered the costs of all the administrative paperwork that goes along with any operation.  Since I refused to lower my standards of care for the shelter animals, I ended up eating the cost of pre-anesthetic blood testing, pain killers and intravenous fluids for every single shelter dog and cat that ever came through here.  In my mind (at the time) it was a small price to pay for doing the right thing.  The real payoff, however, was the prospect of gaining a new patient/client.  The new adoptive owners would come to the hospital to pick up their freshly neutered pet and realize how wonderful our facility was compared to their current animal hospital of choice.

So how well did that pan out?  Not so well.  It turned out that more than 75% of the animals we received from the shelter did not have an owner yet.  The shelter wanted to get the animals spayed and neutered before adopting them out.  So we never had an opportunity to meet or speak with most of these new owners.  In the end, we performed several hundred surgeries (costing us tens of thousands of dollars in labor, medication and supplies) and gained …about eight new clients.  It was not a mutually beneficial arrangement, so we stopped receiving these dogs and cats from the shelter.

Fast forward to 2010.  I met with a shelter administrator who want to know if I would be interested in renewing my contract with the county.  Here is how our conversation went:

“Actually, I may want to do some dog spays for you this summer.  I’m learning how to do laparoscopic spays at the University of Georgia and…”
“Let me stop you right there.  Another veterinarian approached us with the same thing last week. We’re just not interested.”
“What do you mean?”
“We just don’t want to get involved with something so new.”
“Minimally invasive surgery is hardly new.  This is the new standard of care in humans and some veterinarians have been doing it like this for years.”
“We just don’t want to get involved.”
“So you’re turning down an opportunity to get a more progressive, more expensive, less invasive, less painful surgery done at …at the same price to you?”
“Well, what’s involved? Do you still remove the ovaries?”

At this point it be came very apparent that judgment had been passed on the procedure without knowing a single thing about it.

“Yes, both ovaries are still removed.  That’s what makes a spay a spay.  Typically, the uterus is left in.  This can be done with two or sometimes one small incision.”
“OK. I see… Well, we talked to our other veterinarians and they all said that laparoscopic spays were not a good idea for our dogs here.”
“Which veterinarians said this?”
“I’m not at liberty to say specifically.  Just the veterinarians who do our spays for us.”
“They’re wrong. This is just another glaring example of how backwards veterinarians are around here!”

Yup, I said that out loud.  What I managed to hold back were my thoughts of how many swollen, infected and painful surgery sites I have seen on patients spayed via the shelter over the past few years.  A shameful display of high-volume, low-cost negligence.

“Well maybe we’ll change our minds.  Things may change in six months if everyone starts to jump on the bandwagon with this laparoscopic stuff…”
“Unfortunately that will never happen.  You don’t just decide one day to start doing laparoscopic surgery.  You need to get sufficient training, then you need to invest in $10-30,000 of equipment.”
“So you just wanted to practice on some shelter dogs?”
“For lack of a better word, yes. Every dog I spay for you has a greater than 50% chance of being euthanized once you bring her back to the shelter.  I figured you might want to do whatever it takes to get them up and ready for adoption as quickly as possible.”
“Yeah, well …we just can’t let you do that.”

I was listening to the Howard Stern Show on the way into work the other day and Sandra Bernhard was commenting on the ridiculous media coverage of Jon and Kate Gosselin.  She referred to Kate’s overwhelming presence in the media as “a celebration of mediocrity.” I thought that was a wonderful way to express my feelings about some of the veterinarians and animal hospitals I’ve seen through the years.

Now don’t get me wrong.  Most veterinarians are upstanding citizens and practice high quality medicine.  I love my profession, and I think overall we’re a well-respected bunch.  But a few rotten apples will certainly spoil the whole barrel by making the good veterinarians’ jobs more difficult and by making it harder for pet owners to trust their veterinarian.  Why is it that most people don’t trust their car mechanic?  Are all of them out to rip you off? Of course not -but enough bad ones are out there to ruin the reputation of the good guys.

It’s about time we elevate the standard of our profession to better reflect the training and education that goes into becoming a doctor in the first place.  Here’s one of the problems: While it’s really hard to get into veterinary school (at least in this country) and become a licensed veterinarian, it’s way too easy to keep your license once you have it.  In order to maintain my California veterinary license, I need to attend 36 hours of continuing education every two years.  That’s 18 hours a year.  I know accountants who have to attend more CE than that!  In order to maintain my New York license, I merely write a check for $340 every three years.  That’s right folks -no CE requirement for veterinarians in New York State!  That means there are some veterinarians out there who have been in practice for several decades but have not attended any classroom lectures or wetlabs since they graduated from veterinary school back in the dark ages.

What separates the “good” doctors from the “bad” ones?  In reality, I it has much less to do with their actual book-smarts and more to do with their overall medical philosophy.  Does your veterinarian practice medicine as a champion or advocate for your pets? Or do they practice with dollar signs in their eyes and a mortgage on their minds? Make no mistake: good medicine can be quite expensive.  But expensive medicine is not necessarily good.  Examples of bad medicine run the gamut of day-to-day activities in an animal hospital.  It starts with the basics such as giving unnecessary vaccinations or giving every vaccine to every patient every year.  It continues with essential diagnostic tests being run and interpreted by untrained kennel helpers.  Bad medicine even extends into the operating room, where I have witnessed pets being cut open in dirty conditions (e.g, the veterinarian’s necktie falling onto the surgical field), using unsterilized instruments.

The worst part is that none of these “bad” practices are illegal.  They’re just unethical and immoral, and they are against everything we vow to stand up for the in our Veterinary Oath.  And the awful truth is that I will get more heat for writing this blog than any of these bad doctors will get for mistreating your pets!  Will all the bad doctors ever go away? Probably not.  But if you’re taking the time to read this blog, I’ll bet that you’re in the subset of pet owners who is willing to do a little bit of footwork to make sure you’re going to the right animal hospital for you and your pets.

You can find an article I wrote called “How to Choose a Veterinarian” on my hospital website: LevittownVet.com