DrAndyRoark.com

Articles, Videos, & Training on Pets & Veterinary Medicine

Lauren Smith, DVM

Why I Quit My First Job After Only 3 Months

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I was a nervous new grad. Insecure. Overwhelmed. With a major case of imposter syndrome and some serious social anxiety.  

I had put off looking for a job while I was in school, but school was over and the time had come.  I couldn’t procrastinate anymore. After all, those student loan payments were about to come due and Sallie Mae was going to want her money back. So, I sucked it up, ignored the nausea-inducing fear, and started applying for jobs.

I interviewed at a handful of hospitals. Most of them were small one or two doctor practices. The medicine was okay, but there wasn’t much mentorship. I was offered salaries that wouldn’t begin to touch my student loans, and I was going to be on my own a lot. Plus, they lacked… pizzazz. They had paper records and film radiology. The buildings were erected in the early 20th century and had interior design that hadn’t been updated since the ’70s. Maybe I was just looking for excuses not to start practicing, but nothing felt like the right fit.

And then, I interviewed at a large partner-owned practice. It was a glistening practice with marble counters, digital everything and a brand-new surgical suite. There were 10 doctors on staff, they offered 24-hour care, they had a mentoring plan. And they offered a competitive salary with benefits and profit-sharing.  

The decision seemed like a no brainer. This place could give me the opportunity to grow my skills in a safe and protected learning environment. Or so I thought. I optimistically accepted their employment offer.

It didn’t take long to learn that if something seems too good to be true, it probably is. The partners really did only seem to care about the money. They bullied and manipulated clients into unnecessary treatments and tests. Any patient getting X-rays had to spend the night in the hospital, get blood work, an IV catheter, full sedation… “Phone Hours” were from 3-4 pm and that was the only time clients were allowed to get updates on their hospitalized pets. When a client called, the partners would triage which calls I could take, tell me exactly what to recommend, and listen in to my conversation.

I had agreed to a 90-day probationary period, after which I’d sign a year-long contract. I didn’t need 90 days. Almost immediately, I knew this wasn’t the place for me. Less than a month in and I was back on the job hunt. When I got a new offer at one of those older, less flashy hospitals, this time I took it — and put in my notice. 

“I need to set up a meeting,” I told one of the partners not long before my three-month probation was up. It took the partners by surprise. They didn’t think the shy, insecure girl they hired would push back. They thought they could manipulate and mold me into an obedient, little worker bee. 

They didn’t take it well. They tried to gaslight me. “We had an oral contract,” they said.

“There’s no such thing as an oral work contract in New York,” I informed them, mustering up all my courage. “And even if there were, it was for a 3-month period with the option to sign a long-term contract.”

“That was for us to decide if we wanted to hire you.” I just shrugged my shoulders and informed them that it still worked both ways.

They threatened legal action. They tried to withhold the commission I had earned. They told me that as a professional it was only right for me to give them 6 months’ notice (for a job I’d been at less than half that time). They tried to convince me that leaving was a sign of bad moral character – that the other vet hiring me had bad moral character.

But I refused to be a pushover. I refused to let them bully me into getting their way. I refused to compromise my values and the vet I wanted to be.

I was still shy, insecure, and afraid. I had reservations about my decision. There were times I almost believed their conniving words. But I listened to my instincts. I clung to my core values. I found the strength I needed to escape the toxicity.

Because I deserved better. And so do you. 

If you’re in a work environment that feels wrong, your intuition is probably right. If management doesn’t support you, if they pressure you into practicing in a way that makes you uncomfortable, don’t share your values, don’t respect your input… then it’s time to leave.

You don’t need to worry that it will “look bad” on your resume. You don’t need to be concerned that the next job might be even worse. You don’t need fret over whether or not the problem is really you. If you’re in a toxic work environment, you just need to get out.

It’s okay to admit that you made a mistake. Our mistakes can be an important part of our story. That job forced me to rediscover my inner strength. It uncovered my lost confidence. And it taught me exactly what kind of veterinarian I never wanted to be.

Today I work to empower veterinary team members, promote improved communication and relationships between veterinary professionals and clients, and advocate for kindness and compassion. Today, I stand for everything that hospital wasn’t. And I’m not sure I would be who I am if they hadn’t shown me who I didn’t want to be.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

We Can Control Our Actions, but We Can’t Control Outcomes

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I recently went into the emergency clinic where I do relief work to help with a surgery.  When I got there, it was — well a typical weekend afternoon at the emergency clinic. The cages were full of sick patients, the rooms were full of worried clients. The doctor who was scheduled to be on was doing a thoracocentesis — while Dad watched on. Oh yeah, did I mention this was an open hospital where clients come right into the treatment area and are present for as much of their pet’s treatment as they want to be?  That part is less typical.

And so, in the nature of this particular hospital, a client had chosen to stay with her hospitalized dog — for the entire weekend. Hunter had gotten into a bottle of ibuprofen and was clinically fine, but needed decontamination and IV fluids. The client and pet had been set up in the back of the prep room (away from the scrub sink) with an IV pole, and a cot.

And so, as I scrubbed in for my exploratory laparotomy, I chatted with the client. She told me about how she got him and how attached he was to her husband. She told me about how she wouldn’t leave him alone in the hospital.

“You’ve got a really good Mom, Hunter,” I told him.

“No, he doesn’t, he has a terrible Mom. It’s all my fault that this happened.  I left the ibuprofen out.”

I tried to reassure her in the approximately 60 seconds of scrubbing I had left. “You can’t blame yourself.  These things happen to everyone.” I told her about the time I forgot to check the bouquet of flowers I’d received for lilies and my cat wound up in the same position.

We’re only human. We do our best every day, but we can only do so much. There is always going to be a time when we turn our back on that bottle of Advil or miss the lilies right in front of our faces. And sometimes we’ll do everything right and things will still go wrong.

Checkers, that patient with the foreign body, didn’t make it. I knew it was bad the moment I’d cut through the peritoneum. The intestine was tightly bunched and extremely angry looking. There wasn’t a rupture yet, but sharp, chewed up bits of plastic were pressing dangerously into the bowel wall in multiple locations. Three hours, a gastrotomy, two enterotomies, and a resection and anastomosis later, the foreign material was all gone, the abdomen was flushed and closed, the patient was in recovery with a plan for continued treatment, and my colleague and I had done all we could do but cross our fingers and wait and see.

Here’s a little lesson I learned recently. We can control our actions, but we can’t control outcomes. All we can do is the best we can do. After that, we need to let it go and learn to be at peace with whatever may happen.

It’s easier said than done. Hunter’s Mom is going to be a lot more careful with medication from now on, but she may never truly forgive herself for his winding up in the hospital in the first place. And a part of me will always carry Checkers with me — wondering if I could have changed her outcome.

But I am not a God and neither are you (or maybe you are, in which case, it’s pretty awesome that you’re taking the time out to read my insignificant words of wisdom.) The universe is infinitely more powerful than any one individual. What kind of hubris leads us to believe we can control it?

So what’s the point of even trying? Why go to work every day if nothing we do matters? Except that it does matter. We may not be able to control outcomes, but we can influence them. And if that small nudge from me can push the universe in the right direction, then I have to keep trying.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.


The Missing Piece of Preventative Care

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I hate talking about money.

I mean, don’t get me wrong, I can geek out over portfolio diversity and the power of compound interest. But when it comes to the clinic, I’d be happy to never say a word about money again. Most veterinary professionals I know would agree with me. Talking to clients about finances can be dicey.

There’s the problem of dealing with clients who don’t want to pay for the service we provide, or more common still, the client who can’t pay for the service their pet needs. And far too often, we run into the situation of having to make medical decisions for our patients based on finances. Economic euthanasia is one of the worst parts of the job.

Let’s face it, vet med would be much easier if we took the money out of it. But until I catch up to Mark Zuckerberg or Warren Buffet in the net worth category and can finance thousands of no-cost veterinary clinics all over the country, money will continue to be an issue in veterinary medicine.

And here’s the problem — if we stick our heads in the sand and try to pretend our jobs are just about the medicine while ignoring the money factor, we’re setting ourselves and our clients up for failure. And I don’t know about you, but I hate failure; especially when it’s my patients I’m failing.

Now, you might say that it’s not your job to figure out how your clients are going to pay for their pet’s health care. And you may believe, understandably so, that it’s the clients’ job to do their research and make a plan for emergency situations. And that’s true.

But you know what our job is? It’s to educate pet owners on how to take care of their pets. And like it or not, taking care of pets requires big bucks. So why aren’t more of us talking about money preventatively? Just like we don’t want to wait until a pet has been diagnosed with heartworm to talk about heartworm, we shouldn’t wait until a client is in the ER facing a $5000 estimate, to talk about the cost of veterinary care.

Do you know what the average yearly cost to own a pet is? Yeah, me either. I tried to find it for the sake of this article but to no avail. There are estimates for the average cost of routine preventative care. And estimates for the average cost of a single emergency. And those are good starts. But most of us never even breach those numbers with our clients until it’s time for them to pay up. And it doesn’t even begin to cover the cost of dental care, non-emergent acute health issues like UTIs, or chronic conditions like atopy.

And yes, I know it’s hardly a simple matter of giving clients a number. Even if we figure out the “average” it doesn’t mean we have the slightest idea what a lifetime, or even just the next year, of veterinary care is going to cost for an individual pet. An Irish Wolfhound’s medication is going to cost a lot more than a Yorkie’s. A pet in New York City is going to have vet bills that far exceed those of a pet living in rural Alabama. And some clients are going to opt for treatment well above and beyond what the “average” pet owner would consider.

But how can we expect our clients to budget properly for their pet’s care if we don’t even give them an idea of what that budget needs to be? If we continue to hoard information on the cost of care in fear of over or underestimating, then clients are going to continue to be unprepared when the time comes to pony up the money for their vet visit. Pair that with the emotional upheaval of experiencing an emergency with their pet, and it’s no wonder clients lash out. I’m not condoning the abusive, bullying tactics of some pet owners, but let’s face it, during times of emotional stress and fear, people can get a little crazy. And we have the power to prevent that —at least some of the time — by better preparing our clients for the financial reality of pet ownership. Just think how many lop-sided news features could have been avoided if the family in the story had just known ahead of time that emergency clinics don’t offer payment plans?

So, the next time a client comes in with a new puppy or kitten, we need to do more than just educate them on vaccines and parasite prevention. We should do more, even, than suggest pet insurance (though that’s a step in the right direction).  The preventative care talk we have at those new patient and client visits needs to include a candid conversation about the financial impact of pet ownership. We owe it to our clients, our patients, and ourselves to make money a part of preventative care.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

“Thank You for Not Judging Me”

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The day after Christmas started normally for a day in the clinic… with an emergency. Petey had been vomiting since Christmas Eve. By the time he made it to my exam room, he was looking miserable.

“Were there any Christmas parties?” I asked Mom. “Any holiday treats he could have gotten into?”

“No,” she said, “but he does like to chew on his blankets.”

I suppressed a groan. The day after a holiday was always busy, and now I needed to get x-rays. I took Petey back to radiology and got two abdominal views. I groaned again. There, superimposed over his kidney was a dilated loop of intestine with a striated appearance, highly suggestive of a cloth foreign body.

Back to the exam room I went, pulling up the images on the computer for Mom to see. I pointed to the objectional area and explained that Petey needed surgery.

“There’s no way it will pass on its own?” a family member asked.

I shrugged my shoulders. “I never say never,” I advised them, “but I would be very surprised.”

I gave them a ballpark estimate on what surgery would cost and watched as the color drained out of Mom’s face.

“It’s not that I don’t technically have the money,” she explained to me. “But Petey’s 13 already. If he was two, I’d do it no question, but to put that big of a strain on our budget at his age…”

My gut twisted painfully. Every fiber of my being wanted to take Petey to surgery and fix him. Mom was clearly struggling with this decision too, but she had a family to take care of and Petey was only one part of it.

I hated the decision that had been made, but I understood it. Yes, I could save Petey from this problem and no, age is not a disease, but Petey had already lived a long life and his time left with his family was going to be limited no matter what we did.  Just a few years ago, I’d spent thousands of dollars on surgery for my own 14-year-old dog when she developed an obstructive mucocele. With her gallbladder out, the problem was solved. And four months later, she had metastatic mammary carcinoma that no amount of money and medical treatment could save her from.

I told Mom that I understood and respected her decision. Together, we decided that, though we knew it was a hail Mary, we would give Petey 24 hours of IV fluids and gatroprotectants.

As I accompanied Mom out of the room, she turned to me, “Thank you for not judging me for this,” she said and despite my concern for Petey, I felt a warmth inside. Though the chances were small that I would be able to help Petey, I was helping his family.

The following day, Petey looked brighter and he hadn’t vomited at all. We retook the radiographs and the obvious obstruction was no longer visible. The bad news was, Petey refused to eat nor had he had a bowel movement.

We decided to send Petey home. His family knew there was a very good chance the obstruction was still present and he would start vomiting again once the Cerenia wore off, but there was a chance and he was feeling better for the time being.

I spent the next day and a half waiting for the shoe to drop; waiting to hear that Petey was vomiting again. A little over 24 hours after Petey was discharged, I got the call.

“Petey pooped out a tampon and now he’s acting totally normal.” I almost cried with relief.

Mom’s words from the day before rung in my ears. “Thank you for not judging me.” But what if I had judged her? What if I had scolded her for not being a responsible pet owner? For not preparing financially for an emergency like this? What if I had made her feel terrible for her decision? Would I have been able to guilt her into letting me do surgery on Petey? Probably not.

It would have been much more likely that she would have lost all trust in me and decided to euthanize Petey right away, or to take him home against medical advice. Mom would have left feeling terrible at herself and angry at me. I would have spent days stewing in anger and resentment over her unwillingness to care for her pet, and Petey would probably be dead.

I saved a life that day, but not with my surgical skills. My medical training didn’t provide me with the abilities that made a difference. Instead, it was my empathy that won the day. It was my capacity to set aside my judgment and work with a client – even when they didn’t do what I wanted them to.

It can be easy to get caught up in what we believe is right and to judge others for not having the same priorities and beliefs that we do. But being inflexible, demanding, and judgmental are not traits that endear us to others and win them over to our side. Alienating our clients won’t get them to do what we want. So, set aside your judgement and see what a difference you can make.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

In Defense of Laziness

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Stereotypes. We all encounter them every day; from strangers we pass on the street, from clients we see in the clinic, from colleagues at work. Most of us don’t think of being stereotyped by our family, but even within our own homes, stereotypes flourish. We’re the pretty one or the smart one, the funny one or the straight-laced one, the disciplinarian or the “cool” parent. We all have roles in our families.

Growing up, I was the lazy one. I wasn’t really lazy… not by most people’s standards – I don’t think. But I had certain traits that could give one that impression. I was a slob. The floor of my room was always covered in discarded clothing, I’d leave my makeup smeared on the bathroom counter, and homework and papers were strewn all over my desk. My attempts at getting my life organized were chronicled in the empty pages of dozens of planners – used for a week before they were forgotten about and discarded. I wasn’t super social, so I’d spend a lot of time watching TV and whiling away the hours on the internet (to be fair, everything took a long time on the internet in the days of AOL and dial up modems). And, I was forgetful, always so busy daydreaming I couldn’t remember where I’d left my keys or my wallet, or my U.S. History textbook.

But there was more to me than that. I was also an honor roll student, member of the student government, cross country runner, all-county shot-putter, and part time Home Goods employee. You’d think that would be enough to prove my work ethic, but still the stereotype persisted.

Recently, after having issues with my health insurance, my parents started calling me multiple times a day, checking up and pestering me to follow up with the insurance company. “You’re awfully persistent,” I grumbled to my father, fed up with being helicopter parented as a 36-year-old doctor.

“Yes, just like you need to be,” he replied. And in that moment, I realized I still hadn’t outgrown my lazy image. My parents didn’t trust me to follow through on my own affairs. I’m not sure what part of getting into and graduating from vet school, completing several half marathons and one full marathon, being a published writer and starting my own veterinary brand made them think I lacked the persistence to follow through on something as important as my health, but despite it all, the stereotype won out.

But when I stop and think about it, I realize, maybe that’s okay. I mean, stereotypes suck, but there is a kernel of truth in there. In some ways, I was – and still am – lazy. And maybe being “lazy” isn’t all that bad. I didn’t get where I am today despite my so-called “laziness,” I truly believe I got here because of it.

I didn’t waste my time on things that didn’t matter. I still don’t. It’s a rare day in my life where my bed gets made. I often leave dirty dishes in the sink (and no, I don’t have ants). I don’t bother sorting junk mail and my books are not arranged in alphabetical order. And all that extra time I save not worrying about the little things give me the time I need to devote to the things that matter to me without getting burned out.

And yes, I still spend an inordinate amount of time lost in my own thoughts, and yeah, that leads to a lot of time spent searching for my cellphone, but studies are increasingly showing that this can be the marker of a creative mind. Time spent daydreaming about the future instead of worrying about the past, helps me come up with ideas for blogs, and set big goals for myself. Searching for things in a mess helps me stay creative by forcing my mind to think outside the box.

Watching TV and reading, especially fiction, isn’t just a way to destress and recharge, and it’s not just wasting time. Engaging in fictional worlds has been shown to increase empathy which helps me be a more effective veterinarian and writer.

So maybe I am a little lazy. Maybe I am a bit scatterbrained. Maybe I’m a disorganized mess. And maybe, just maybe, we could all benefit from being a little lazier and less organized too.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Why You Should Strike the Word “Radiograph” From Your Vocabulary

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Sometimes after a big, nasty mass removal, or other messy surgery, I look down at my blood-splatted scrubs and think to myself, I sure hope I don’t get pulled over by a cop on the way home. This is often followed up by me thinking about what would happen if I did get pulled over by a cop.

He’d probably ask me to get out of the car. He’d pop my trunk looking for the body. I’d try to explain that I’m a vet and it’s dog blood from a still alive dog who was anesthetized at the time the blood was spilt. The nice police officer might still be a little suspicious, so I’d need to prove myself.

“Hemangiopericytoma,” I’d say, or some other big, important-sounding medical term. After all, only a doctor would know that word.

Now, you’re probably wondering where I’m going with this story. Is there a point other than the fact that I’m super weird and have very strange daydreams?

There is. And that point is that words are powerful. Certain words can make us feel smart and important. They can give us identity. We spent a long time learning the language of medicine. My first year of vet school, I sometimes felt more like I was learning a foreign language than learning medicine. And what’s the point of memorizing all those fancy words if we never get to use them?

I found the lure of “jargon” to be especially alluring when I was a new grad. I was young and inexperienced, and I needed people to trust me and believe I knew what I was doing. So, I threw out the big words with abandon. Look how smart I am, I can tell you your dog has gastroenteritis. You cat has an eosinophilic granuloma.

But the truth is, these words may make you feel smarter, but to clients, they often just make you sound like a smart ass. When you tell a client that you’re taking their pet for a radiograph, most of them will give you a blank stare. And they may even feel stupid for not know what that means. Then, they’ll start tuning out of the rest of what you have to say.

I know, I know, our professors drilled it into our heads: X-rays are the electromagnetic currents that are used to generate the image, radiographs are the images themselves. But we’re not in school anymore (unless you still are, in which case, save this lesson for a rainy day).

I got into an argument online about this one day. I (ever so politely, I swear) explained that very few clients know what the heck a radiograph is.

“You’re right,” the person said, “next time I’ll make sure to explain the difference between an x-ray and a radiograph to them.”

I must have pulled a periocular muscle I rolled my eyes so hard (my intended audience here is vet professionals so the word “periocular” is fair game). Clearly, I wasn’t communicating well if that was her take away from what I’d said.

Honestly, do you think your clients care about the difference between an x-ray and a radiograph? Is that really what you want to spend your time explaining to them, when you could be explaining what that distended, gas-filled loop of bowel means? Your client doesn’t want to know if you can recite Dorland’s Medical Dictionary, they want to know that you can fix their pet. And if you can’t fix their pet, they want to know what you can do to relieve their pet’s suffering.

It’s tempting to use medical jargon when explaining a medical problem. It’s quick, descriptive, precise—pyogranulomatous inflammation with bacterial sepsis is a beautiful phrase — if you know what it means. But it won’t help you connect to your client. It won’t tell them what’s wrong with their pet. It’s not likely to inspire compliance when you suggest an expensive culture, then tell them to come back for a recheck. You need to speak to your clients in terms they can understand.

The truth is, you can be the smartest person in any room, but if you can’t effectively communicate your knowledge to someone else, you’ll never be a great clinician. As practicing doctors (or techs) we need clients. We need them to agree to the diagnostics we recommend, we need them to administer the medications we prescribe, we need them to bring their pets back to us. And to make any of that happen, we need our clients to understand us. So, stop with the medical-ese and speak a language your client can understand.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.