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Andy Roark DVM MS

Should Vets and Clients Be Facebook Friends?

May 9, 2013 by Andy Roark DVM MS

It just happened again. The little head-shaped silhouette in the top left corner of my Facebook page lit up, and a wonderful pet owner I recently helped reached out to be my online friend.

I have seen Mrs. Morgan a half dozen times in the last six months, and she is delightful. She has two English Springer Spaniels and a rabbit named Professor Snacks. (That name alone earns her huge points with me.) She seems like one of the sweetest people anyone could meet, and I’d love to be connected to her and her pets.

Kitten On A Laptop

But just before I click the button to accept her as a Facebook connection, a surge of worry shoots through me. I think of how she might respond to some of the things I post on Facebook to friends and family. Will she be offended by reports of my parenting blunders, profanities in any of the articles I share or flippant comments about hard days at work? What will she think when she realizes that being a veterinarian is only a part (albeit a significant part) of who I am as a person?

What if there are things about her I don’t want to know? What if she tries to change my religion, sell me cosmetics or criticize me for activities that take me away from the clinic? What if she expects me to be on call for pet questions, comments and emergency care 24/7?

Continue reading…

 

Originally Published: Vetstreet.com – May 9, 2013

(Click Here To View Original)

Filed Under: Blog Tagged With: Life With Clients

Are Annual Exams Really Necessary?

April 25, 2013 by Andy Roark DVM MS

 

Last year, in a much-discussed New York Times article titled “Let’s (Not) Get Physicals,” a physician reporter named Elisabeth Rosenthal argued that annual physical examinations for human patients are pointless. She cited a Canadian government task force recommendation to abandon annual physical examinations because they are “nonspecific,” “inefficient” and “potentially harmful” (in that they may lead to unnecessary tests). The task force said examinations should be replaced with intermittent screening tests for age- and risk-specific conditions (mammograms, Pap tests, etc.). Dr. Rosenthal argued that this logic is sound in the United States as well.

 

White Labradors

 

Scrutiny of annual physical examinations for people does not come as a surprise. Health care costs are soaring, and research consistently shows annual physicals don’t save lives. Most treatment is started because a patient feels sick and comes to the doctor — not because of findings in a routine examination.

 

So, do these human-side rumblings mean that we should re-evaluate the annual or biannual examinations that veterinarians recommend for pets? Are those trips to the vet with seemingly happy, healthy pets really worth the stress and effort for all involved? I’ve asked myself those questions repeatedly. Here are the key points I always return to.

 

Continue reading…

 

[tweetthis]Are annual exams necessary? [/tweetthis]

 

Originally Published: Vetstreet.com – April 25, 2013  [Republished on Yahoo.com]

(Click Here To View Original)

Filed Under: Blog Tagged With: Care, Life With Clients

How to Say Goodbye

April 16, 2013 by Andy Roark DVM MS

Just last week, while I was performing euthanasia for a critically ill patient, the pet’s owner looked at me and said, “I bet this is the hardest part of your job.” That gave me pause.

For me, putting animals to sleep is not one of the hardest parts of being a veterinarian. That’s because euthanasia is often a blessing and gift to a suffering animal. In my experience, the hardest part of being a veterinarian is telling owners that their beloved pet has a terminal illness and will soon be leaving this world. The emotions that pass across their faces, even if they have suspected the worst for some time, are heart-wrenching.

Sad Cat

It’s Never Easy

I still remember the first person I had to share this terrible news with. He was a nice, middle-aged man with two small children and an 8-year-old Rottweiler named Stone. Stone was a member of the family, and when he started to limp, his owner brought him straight in to be checked out. Stone was a wonderful dog at home, but he was not a fan of the veterinary clinic. My best dog treats did nothing to warm his heart, and when I manipulated his painful left shoulder, well… that ended our chances of being best friends.

Even though Stone was not an admirer of mine, I liked him, and I really liked his owner. That made it so much harder to discuss his diagnosis: osteosarcoma. Osteosarcoma is a painful bone tumor that responds poorly to treatment. In some cases, treatments involving limb amputation and/or radiation therapy can be beneficial. In Stone’s case, these options were not feasible.

Continue…

 

Originally Published: Vetstreet.com – April 16, 2013  [Republished by Yahoo.com]

 

Filed Under: Blog Tagged With: Euthanasia

My Veterinary Pact With You

March 11, 2013 by Andy Roark DVM MS

Successful relationships are based on clear expectations and commitments. For example, when I go to my favorite restaurant, I know I can expect their usual level of great service and delicious food. And the owners can expect that I’ll pay my tab, behave nicely and respect the “No shirt, no shoes, no service” sign. I hold up my end of the deal, knowing that they’ll hold up theirs, and vice versa. Same goes for my children’s day care. I bring my kids in clean, germ-free and with healthy lunches packed, and the staff does their part to make sure that my children are cared for, educated and looked after until I arrive on time to pick them up. We each know what to expect from the other.

As a veterinarian, I had a brainstorm the other day: What if expectations between pet owners and veterinary teams were just as clear? We each have our needs, abilities, strengths and limitations. Would we understand each other better — and work better as a team to care for pets — if we agreed on what’s fair to expect of one another? I think we might. Here’s what I believe pet owners should expect from me — and what I hope I can expect from them in return:

1) I, your pet’s veterinarian, promise that I will always act in your pet’s best interest. I’ll listen (I mean really listen) when you tell me what your concerns and questions are. In return, I ask that you remember that I am a human being, flaws and all. I have only two hands and one brain. At the end of the day, I have a family to go home to, too. I’m just a person, but I’ll be the person who puts your pet first whenever I see him or her.

Continue reading…

Originally published by Vetstreet.com.

Filed Under: Blog Tagged With: Life With Clients

Veterinarian Confession: “I Don’t Brush My Dog’s Teeth”

January 7, 2013 by Andy Roark DVM MS

Mrs. Griffith sighed as she gently separated her youngest daughter and oldest Labrador Retriever. She stepped between them and over a discarded pacifier to look me directly in the eye. “Really?” she asked. “Do you brush your dog’s teeth every day?”

It was a moment of truth. She didn’t ask me what I recommend. She asked me what I do.

The best thing for her dog’s dental health is a daily tooth brushing with pet-safe enzymatic toothpaste. Unfortunately, the problem with my being a real person — one with a working spouse, young children, two jobs and a few hobbies — is that what I know to be “the best thing” and what I actually do at home are occasionally not the same. Mrs. Griffith had a lot on her plate at home, too, and when she asked me for honesty, my credibility was on the line. I wasn’t going to lie to her, and I’m not going to lie to you either.

I know exactly how dental disease affects pets. I know that the dental tartar you see slowly building up on your pet’s teeth is about 80 percent bacteria and that it damages the gums, the bone beneath and the ligaments that hold teeth in place. This bacteria can gain access to the blood stream and infect vital organs like the heart, lungs and kidneys. I also know that advanced dental disease hurts; it makes pets feel sick. Daily brushing is the best deterrent.

But like 95 percent of pet owners, I don’t regularly brush my dog’s teeth, even though I know it’s the best thing for his health. Still, that doesn’t mean dental health isn’t on my mind. Here’s what I do instead:

Continue reading…

Originally Published by Vetstreet.com.

Filed Under: Blog Tagged With: Care, Life With Clients

Manage Veterinary Clients’ Requests for Special Treatment

November 1, 2012 by Andy Roark DVM MS

Manage Veterinary Clients’ Requests for Special Treatment

Originally Published: DVM NewsMagazine, November 1, 2011

 

 

I drop into my office chair, flip open the puppy’s chart and start frantically writing. I’m 15 minutes late for my next appointment and clenching my teeth. Even my eyelids are tensing with stress. When did I start carrying emotional tension in my face? Is it even possible to do stretches for these muscles?

With no time for a facial yoga session, I glance toward the appointment schedule for the rest of the morning. It’s packed, and it’s not looking like this day is going to end anywhere near our 1 p.m. Saturday closing time.

Before I can rush out the door to meet my next client, the phone lights up. “Dr. Roark, Ms. Nuñez is on the phone, and she says she’ll speak only to you.”

I know what this means. I have crossed paths with Ms. Nuñez before. She’s a loving cat owner but a demanding client and master negotiator. (Takes one to know one: I once talked a limo driver into loaning me his snakeskin boots when a nightclub bouncer took exception to my tennis shoes.) Our conversations feel like they should take place at Camp David.

As I press the flashing button to take the call, I run through the negotiation tactics I know she’ll use against me. Any of these sound familiar?

Get to the decision maker

If a client wants baseless discounts, waived emergency fees or complete circumvention of scheduling protocols, the doctor is whom they ask for. No one else has the authority, or lack of common sense, to make these things happen. So Ms. Nuñez insists on speaking to me directly. She’s off to a solid start.

Create a looming deadline

As soon as I pick up the phone, Ms. Nuñez jumps into the details of her visit to the emergency clinic the previous evening and the impending doom that looms over her cat, Petie.

Petie, it turns out, has had a urethral obstruction and, while he has been catheterized, Ms. Nuñez knows deep in her bones that the cat needs a perineal urethrostomy…right now. She is adamant that re-blockage is imminent and that leaving the patient at the emergency clinic until Monday is simply not an option. She feels surgery must be done immediately—but not at the emergency clinic (or at emergency prices).

Go heavy on flattery

Once she lays out the urgency of the situation, Ms. Nuñez targets my ego. She is certain, she says, that I can help her and do a better job than anyone else. I am, after all, the best veterinarian she’s ever met. (Fortunately, the stress tension in my face prevents my head from expanding noticeably.)

Understand the other party’s priorities

We, as veterinarians, deeply want to help animals. Ms. Nuñez knows that her cat’s health and quality of life are more important to me than money. She is also willing to bet that they’re more important to me than my Saturday afternoon. She uses this knowledge and ends her impressive pitch with, “Doctor, please don’t let my kitty suffer! You’ll save his life, won’t you?”

My mind races as I try to form a response.

She’s made her case so masterfully, I’m almost ready to book the after-hours appointment and risk mutiny by my technicians. But no. Today, I’ll do what makes the most sense for everyone involved, including Petie. I’ve got some negotiating strategies of my own. Here they are:

Recognize the pitch

As soon as a client demands to speak to me and me alone, I go on high alert. This is someone who’s looking to bypass the regular guidelines of the practice.

Control your heart

As her frantic story unfurls, I force my analytic brain to prevail over my warm and fuzzy side. I care about Ms. Nuñez’s cat, but I can’t let that emotion blind me to the consequences of my decision. I must also care about all the other pets who are scheduled to come in, my staff and their time, and my own family.

Understand the other side

Often, we think we know our clients’ priorities, but we rarely know the entire story. I ask Ms. Nuñez why she doesn’t want the surgery done at the E-clinic. She tells me first that it’s because she feels so good about working with me (back to the flattery), and then that the estimate is very pricey. Finally, she tells me she just doesn’t know these people, and she’s scared. Now I really understand where she is coming from.

Slow down

Ms. Nuñez has thrown a lot of information at me at once. None of it has been verified by the veterinarian she saw last night, and all of it is emotionally charged. My next goal is to get off the phone, so I can think clearly and quietly. “Did the emergency clinic fax me your record?” I ask. “I’ll review it as soon as I can and call you back in a few hours.” She nervously agrees to wait, and now I have time to unclench my face and contemplate my options.

Think through the whole scenario

After a few moments of reflection, I am certain that, though I want to help, I won’t be seeing Ms. Nuñez and Petie this afternoon. To do so would make my technicians work well past their scheduled shifts, leave my patient unsupervised after the procedure, and force me to do a solo surgery I am not comfortable with—not to mention strand my wife at home with a young child and infant. Rationally, I just can’t agree to it.

Address concerns, offer options

When I have reviewed the record, I call Ms. Nuñez back. I tell her I want to help, and that her cat’s health is my top priority in making a plan. I answer all her medical questions and then explain that I am not comfortable with the surgery, nor do I have the necessary staff available.

I tell her that I have great confidence in the E-clinic, which helps address her fears about dealing with unfamiliar people. I also tell her that I will support her in either having the surgery there or continuing supportive care until Petie can be transferred to me (and a more experienced surgeon) on Monday.

Step away

I have given Ms. Nuñez all the information she needs to make an educated decision on her pet’s care. I tell her she can think everything over, confer with the emergency doctor, and then let me know how she wants to proceed.

An hour later Ms. Nuñez decides Petie should have the surgery and come home as soon as possible. With my endorsement of the E-clinic, she feels comfortable going forward with the procedure there. She tells me that she will plan to see me when Petie needs his sutures removed.

I have no doubt she will talk me into doing it for free.

Filed Under: Blog Tagged With: Life With Clients, Medicine

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