Funny Vet

Does anyone understand the importance of the nodding technician?  I don’t mean just mindless, bobble-head nodding, but directed assent.  It’s an art.  You think the client is listening to you in the room?  Pfft.  No.  They are, however, looking toward your technician as a third party in the room and a well-timed nodding to whatever it is you’re saying can mean the difference between compliance or applying the figurative brakes.  Oddly, clients may resist what your technician has to offer in a one-on-one setting, such as pre-surgical bloodwork or making an appointment with the doctor.  Yet, in a setting where you, as the veterinarian, are discussing options, or plans, or giving instructions, the client will invariably look for that non-verbal clue from your technician (a sort of subliminal unsolicited body-language advice) to decide whether you actually know what you’re talking about or whether you’re a nutter.  Yes, the gray hairs, the degrees on the wall, all that fancy-talk you have, mean nothing next to a well-placed nod of agreement.  And certainly it does you no good if your technician is sighing, displaying silent scoffing or mocking, or imploying the infamous eye-roll.  So, some training may be necessary.  Sometimes I like to get my staff to throw in an “Amen” or a “Hallelujah, brother” just to add some variety.
Does anyone else have the thought, as they’re rooting around trying to express a pet’s anal glands for instance, “Hey!  I have a doctorate!”  Yes, that’s right!  It requires eight long years of school to put that finger there!  Congratulations!  You realize that without that advanced degree, what you are doing could be illegal in several states.
I find it amusing when I have new clients (and this goes off something I spoke to in previous blogs) who are in only for a rabies vaccine, in which the paperwork takes longer than actually doing the vaccine, and afterwards the clients gush how much they like me and what a great doctor I am!  “You’re the best!” I’ve been told.  To which I can only reply, “Yes, yes.  I give good rabies.”
I’ve been thinking of adopting an Australian accent.  Americans really seem to like such accents and I thought that I might increase compliance by doing so.  I think we all are more intrigued and listen better when confronted with English or Australian accents.  I distinctly remember that when we had a couple of male Australian lecturers come speak at our vet school, the estrogen wave that went through the class threatened to wash over the social levees.  Certainly, there was a greater response to them than to that guy from “Bahston”.  Clients might even infer some exotic value to a perhaps more glamorous background and education.  If I were to do it I would have to remind myself that with Great Accent Comes Great Responsibility.  Hmmmmmmm…..maybe a nice Scottish brogue.
Isn’t it interesting how animals aren’t getting sick anymore?  We’ve really noticed a decline in the past, oh, let’s say, three to four years.  I think it must be that clients are finally listening to our sage advice and doing preventive care - feeding properly, getting their pets exercise, doing regular ear cleaning, keeping up on their routine physicals and vaccines.  Oh, wait, no, that can’t be it.  Because we’ve seen a decline in those types of visits as well.  Maybe it must have to do with the increased number of pets not spayed or neutered I’ve seen lately.  Perhaps they are healthier because of that?  That doesn’t make a lot of sense.  Perhaps people just have fewer animals?  Hard to say.  I mean, I’m sure if a family pet were sick, even in this economy, that people would certainly still be as quick to take care of them, right?  So, it must be something else.  I guess it could be those fantastic rabies vaccines I’ve been giving have more to them than we thought!  Well, mate, no worries!  We’ll just have ourselves a game of Two Up and veg out later, watch some aerial pingpong.

Has anyone else looked up reviews about themselves or their business on the internet?  C’mon admit it.  You know you have.  I have and found them to contain the most useless of information.  One of the first things you’ll notice is either they love, love, love you or hate, hate, hate you.  There seems to be no middle ground.  No real discerning or parsing or analysis of positive and negatives.  They’re very synaptic: all or nothing.  The funny thing about these reviews is you can make yourself feel great if you only read the positive ones and you can feel wretched if you only concentrate on the negative ones.  In a little place I like to call “reality”, we probably all fall somewhere in the middle with our own basket of strengths and weaknesses and if you know yourself and your staff at all, you’ll know if you’re doing a good job or not.  One thing I learned a long, long time ago in a restaurant far, far away as a food server, was it is impossible to please everyone.  That has continued as an observation to this day.  Also, it seems some people leave the house with the intention of having a bad day.  Or at least making someone else have a bad day.  The first five years after graduation I found myself internalizing every little piece of advice and criticism that clients would give.  And they were and are always willing to give.  After five years I found (according to the clients) that I still wasn’t doing everything for everyone right and yet I had been constantly and diligently working on improving.  It was about this time that I stopped listening.  Not to sound obstinate or close-minded, but I stopped internalizing the criticism.  Sure, there’s room for improvement for everyone, but as long as you be yourself and you do your best there’s not much more anyone can ask of you.  You can drive yourself nuts taking in all of the advice that clients, colleagues, veterinary business magazines, society, etc. gives you.  Look, some people are going to like you and some people are not.  I’m contrary enough that the people who have had exactly one visit with me who think I’m wonderful and the best doctor in the world worry me more than the ones who don’t like me right off the bat.  Because while I’ll always do my best for people, if you put anyone on such a high pedestal so quickly, all I can think is, “You’re in for some disappointment in the future.”  Do yourself a favor when you feel a bit down that all of your reviews on-line aren’t stellar and glowing.  Look up other businesses or vets from your class or ones you have worked with.  Not only can it be mildly amusing, you’ll also see they have the same distribution with some people adoring them and other people hating them with the fierceness of a thousand Chihuahuas.  The other thing I’ve noticed is that with an active client population in the thousands, we have less than a dozen reviews.  Hardly a statistically significant sample in the first place.
How is it that everyone knows a veterinary technician?  You know what I mean.  They’re the vet tech that “lives next door” or “used to work at their previous clinic” or “my sister knows”.  And this mystery person is always brought up to justify some strange thing that the client has done.  “I put yogurt in the ears because he has an ear infection.”  “I put cornstarch in the pee-pee folds to fight off yeast.”  “I’ve been adding colloidal silver to the water to help heal her broken leg.”  All advice placed firmly at the feet of the authority of the unknown vet tech.  I think they’re an urban legend.  You know, like the Vet Tech With The Hook For A Hand or The Hitchhiking Vet Tech.  Outside of my clinic I don’t know anyone who is a vet tech.  Yet, a great portion of my clients seem to know someone who is or has been one.  But if you try to pin your client down, suddenly its two- or three- people removed from them, like the veterinary version of Six Degrees From Kevin Bacon.  And no one can ever produce an actual person or phone number that you can contact the mystery tech and tell them to stop dispensing bad advice.  Sometimes I think there must be only one person (maybe it IS Kevin Bacon), because the same bad advice crops up from different clients.  Either one person is just very busy undermining the profession or vet techs are as ubiquitous as sneezes in cold season.  Certainly, on-line everyone seems to be a vet tech.  But, then, everyone on-line is beautiful, intelligent and wealthy also.  I do appreciate to some degree the ones on-line who identify that they are not a veterinarian or veterinary technician.  But then they go on to give wrong advice anyways.  And the fact that people will just accept information no matter how outlandish is appalling too.  “Yeah, well, I’m not an auto mechanic, but I think if you just jigger this little valve here in the anacanafranastan, you shouldn’t have to take it in.”  I think the urban vet tech legend is our profession’s more specific answer to “They”.  As in, “you know what they say” or “they say (fill in inane comment here)”.  It’s that ambiguous, ephemeral nonsense that we fight everyday and yet it has the tenacity of a starved pit-bull in the minds of the public.  I’m constantly amazed, here in the 21st Century, knowing how much we dispense advice daily, that we still have to battle against what can only be termed a Force of Nature; one that we call Ignorance.  And, unlike hurricanes, there is no season for it.

I received my monthly newsletter from our friends at AVMA PLIT with its prerequisite number of horror stories to prove why we need insurance.  I always get the impression that the insurance companies are just contemporary Mafioso enforcers.  They come to your business and say something along the lines of, “You got a nice place here.  I’m sure you wouldn’t want anything to happen to it.  It would be a tragedy.  You know we could provide you some…..protection, if you know what I mean.  There would, of course, be a nominal fee, but I’m sure you can see how reasonable we are.”  A few things I get from reading the stories.  One: someone doesn’t even really need to do anything wrong; it can just be the client’s alternate-reality version of events.  Two:  don’t do equine medicine; who would ever think such a large expensive animal can break like the most fragile crystal.  “Whoa!  Your technician looked too hard at my mare three years ago and now her (name any leg part) is broken!”  Third:  does anyone else notice that it’s the same doctors who are in trouble every month?  What is up with these guys?  Drs X, Y, and Z are constantly in trouble!  They’re like the Three Stooges of the veterinary world.  Seems to me if we can just get these three guys to stop messing up, perhaps our insurance rates would improve.
So, Mariah Carey isn’t able or doesn’t wish to pay her vet bills.  What kind of message does this send to our average clients?  I can already hear it.  “See, how expensive veterinary medicine is?  Poor Mariah can’t even afford it!  That vet of hers just charges way too much!”  Which, then, would lead to the next logical client conclusion: “If someone as well-off as Mariah doesn’t have to pay her vet bills, why should I?”  This is just the latest entry in the long list of justifications as to why they cannot pay or go forward with diagnostics or treatment.  One of my favorite entries on that list: “We can’t afford to do (treatment X) because we just got back from vacation in the Caribbean!”  I don’t know what services and over what period of time would eventually amount to $30,000, but I’m certain that it wasn’t just a spay.  Veterinary medicine continues to be an amazing deal, especially in comparison with other medical professions, for the money involved.  While in veterinary school, my wife had to have her gall bladder out – no insurance at the time.  Came to about $10,000.  A veterinarian could have done the same procedure for $1,000 or less.  And, though we had to make payments and had to deal with a less than sympathetic hospital bureaucracy, we still paid the total of the whole bill over time.  I’m sure few people will get the point that Mariah’s veterinarian probably let things slide for quite awhile before being pushed into having to pursue the matter legally.  At least with the vets I know or have worked with, it would take a lot for them to become confrontational about a client paying their bill.  No one wants to be that paperboy from Better Off Dead shouting, “I want my two dollars!”  And it’s weird, too, because every year we top the list of most respected and most honest of professions, but I don’t see that translate to real life.  Respect could be represented by accepting our fees, accepting our advice, showing up on time for appointments, clients paying their bills, etc.  Too many clients continue to respond as if we are used-car salesmen or auto mechanics that are trying to take advantage of them in some way.  If Mariah doesn’t pay her vet, where does it end?  Next thing you know, Angelina Jolie doesn’t pay her vet, Tim Robbins doesn’t pay his.  It may even get so bad that Betty White and Bono don’t pay theirs!  Then wholesale anarchy and economic collapse descends!  So, Mariah, for the sake of the world, pay your vet!
PetMedExpress commercials are shortening my life-span.  Between the insinuation that veterinarians are just ridiculously expensive to the fact that the mailman in some way is related to the whole PetMed happiness scenario with the dog greeting him so enthusiastically.  It’s the mailman!  He doesn’t work for PetMed!  The dog isn’t greeting him because of the amazing convenience provided.  What’s strange, too, is so many clients order the medications on the same day or the day after being at the vets.  So, where’s the convenience?  You were just there!  You could have just had your meds filled right then!  And, truly, have we become such lazy asses that it’s become impossible to drive a couple of miles to pick up medications?  “Well, I’d have to get dressed.  And tie my shoes.  And then there’s the traffic.  And what if I have to wait for them to actually fill it?  It’s just so tiring.”  The phrase so often repeated in their ads is how their medications are “a lot” less expensive.  Not  necessarily.  More often than not there is less than a dollar’s difference.  Nothing like supporting your local businesses.  If you don't support your local vet, how do you expect them to stay in business?  Don’t think you can call PetMed up should you have an emergency or need surgery or hospitalization.  I’m amazed by how little clients will actually research to see if the medications they are ordering are less expensive on-line.  Sometimes they’re not and we point that out to them.  I had one client who still wanted to get the medication on-line, though we explained that it was more expensive, with the wonderful logic of, “Well, you can tell me anything, but that doesn’t make it true!”  Really?!  What would I benefit from lying?  You can verify it for yourself!  Here’s our cost and you can look up for yourself their cost.  Oh, shoot, that’s right.  That would require effort.  I forgot.  You’re still trying to tie your shoes.