In veterinary school, our ER clinicians had one rule that still sticks with me today: “Never talk badly about the referring DVM to a client.” One important reason for this rule is that the client’s report of what the other vet said may not be exactly accurate.
Whether the client was distracted by emotional distress or just plainly misunderstood, it’s not uncommon for the original veterinarian’s intent to become misinterpreted in that game of telephone. “The other vet said to give omega 7 skinny acid, purple-monkey-dishwasher.” Hmm, that doesn’t sound quite right. (And congratulations to anyone who caught that reference to an early TV episode of a certain yellow cartoon family.)
Now let’s address the more uncomfortable situation when you know exactly what was done and disagree with a colleague’s treatment plan. We often encounter this in multi-doctor hospitals or between competing practices. It’s common, especially in this current era, to be critical of colleagues if they are doing something differently than you.
Even though our profession has standards of practice, few veterinarians have exactly the same preferences. What do you say when your preference is different than the previous vet? And while you’re contemplating that question, also put yourself in the other vet’s shoes. How would you want a vet who disagrees with you to speak with your client?
Here are my 6 “Courtesy Commandments” for respectfully disagreeing with a veterinary colleague. (And yes, I realize if I say “commandment”, there should probably be 10 of them. Please have the courtesy to let that detail slide.)
Never bad-mouth another veterinarian in front of a client.
Just don’t do it. This is my most important “Courtesy Commandment.” I understand it can be tempting, but tearing down a colleague is not the best way to build yourself up. Okay, maybe in the short term some clients will respond to this and only want to schedule appointments with you, but you will lose respect from your colleagues.
Especially if you do this to the other vets in your own practice, it will create a toxic working environment. Don’t be that vet that all the other vets hate. Also, remember that game of telephone? The same philosophy applies here when a client reports back about what you said. Having a client tell another vet that you said they do things incorrectly is a bad idea. Bad idea. You’re just asking for your words to be misconstrued, which could come back to haunt you. Don’t fall into that trap.
Acknowledge what the other vet did correctly and what you learned from what the other vet has already done.
If the patient did not respond well to the previous veterinarian’s treatment, explain what you can infer from that and why you would like to take a different approach. This is extremely important if the client is complaining about vets who also work in your practice. Those vets may not get a chance to defend themselves, so this is your chance to take a moment to have their backs and restore the client’s confidence in them even though their initial choices may not have been successful.
Hopefully your co-workers will have the same professional courtesy for you, too. I would also wish that even competitors could show each other similar courtesy. Maybe that’s unrealistic, but can’t I dream about a wonderful veterinary utopia where everyone is nice to everyone?
Avoid using negative phrases when discussing previous treatments a patient received, and instead focus on what your plan is now.
This doesn’t throw the other vet under the bus, but instead builds the client’s confidence in you because your goal is moving forward to make their pet better.
Explain to the owner why you prefer something different.
You can still be a good advocate for your methods without putting down your colleagues. For example, try to get the owner excited about doing something different by explaining why you personally prefer that option. Attempt to put more effort into explaining the benefits of your preference than into emphasizing the negatives of the previous treatment.
Don’t be afraid to continue treatments that are working.
If the client is very happy with a previous treatment that is working and that treatment does not put the patient’s health at risk, then consider continuing the previous treatment even if it’s not how you usually would approach that case. To clarify, I’m not encouraging you to blindly continue treatments you are uncomfortable with. Still, try to keep an open mind. Discovering that a treatment different than your preference works best for that pet is not a defeat. That’s just the nature of medicine. You may just learn a new approach that could be used for your other patients in the future.
If you truly believe another veterinarian made a mistake, discuss that directly with the veterinarian.
I want to acknowledge there is a huge difference between disagreeing over a preferred treatment and recognizing a colleague is practicing inappropriate medicine. I still believe the above suggestions are a good guideline of professional courtesy toward each other, but I concede that special situations exist. There are protocols in place for reporting malpractice, but I would recommend speaking with that veterinarian first. That is the kind of professional courtesy I would hope someone would have for me if the tables were turned.
Veterinary medicine is a small profession. We need to have each other’s backs. Veterinarians will never agree on everything, but that’s okay. Disagreement is healthy and promotes progress in our profession and our individual hospitals. My utopian dreamland where all vets just get along will never exist. However, I think discussion of disagreements must be conducted in a respectful manner, especially in front of clients. Hopefully these “Courtesy Commandments” encourage that. We have enough drama to deal with. We don’t need to add any purple-monkey-dishwashers.
Dr. Michael W. Miller, DVM is a part-owner of a four hospital practice and splits time between Lakewood Animal Hospital and Pine Bluff Animal Hospital in Morris, Illinois. He has a special interest in exotic animal medicine – especially reptiles, but he also enjoys working on dogs and cats including his mischievous shelter mutt named Wombat.