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Nicole Palumbo, DVM

The Main Way Clients Fail Their Pets

December 26, 2017 by Nicole Palumbo, DVM

Compliance sounds like such a simple word, but unfortunately, that is all that stands between successfully managed pets versus a failure.

A veterinarian is just an advocate for your pet. You are the one who is fully in charge of your pet’s life and treatment.

One of the most frustrating things that a veterinarian deals with daily is non-compliant owners and those non-compliant owners blaming the veterinarian for the failure of treatment.

Here are a few examples:

1.Dog was given three weeks’ worth of antibiotics for a urinary infection.

The owner brings the dog back four weeks later and says the dog wasn’t any better. When asked how they did on the antibiotic they state they stopped it after two days because it made the dog vomit.

They never called to discuss a different medication or that the animal was sick on the prescribed medicine. Now they are upset they have to pay another office call.

2. Dog just had major surgery on its back leg.

The take-home instructions state, “Do not allow outside by themselves- strict leash walk outside only.” On day two, the owners let the dog run outside unattended. Dog falls into a divot in the yard and breaks its leg. Now the dog needs a second surgery. The owner is upset with us.

3.Cat was diagnosed with hyperthyroidism.

The owner comes back for a recheck and the cat is worse. Cat hasn’t been eating for a week. Cat also isn’t getting his medication because the owner doesn’t want to deal with giving a pill. Owner is mad because cat isn’t better.

4. Cat has fleabite allergies.

Even though it is an indoor cat it has a terrible reaction to any fleas that may bite it. The owner continues to bring the cat in every two to three months stating the cat just needs an allergy injection.

Every time we discuss keeping the cat on flea medication year-round and every time the owner says he won’t do it. The cat is going to continue to have problems but we are the ones to blame.

5.Dog comes in for vomiting and diarrhea.

Nothing major found on exam. Sent home with medications to help and owner is instructed to call after 24-48 hours if no improvement. Owner calls a week later saying the dog died and it’s our fault.

Do you see the pickle this puts us in?

I love my patients. I want what is best for them. I frequently send home detailed instructions on what owners are supposed to do to treat their furry friends but none of that matters if the owners are not compliant.

Many owners aren’t upfront about what they can or cannot do. Some feel embarrassed they cannot medicate their animal or that they let the animal get so sick, to begin with. I get it. But you need to understand that you are ultimately in charge of your animal’s health.

So please, give your pets their antibiotics until the bottle is empty (you should never have leftover), call us if the animal isn’t getting better, follow surgical instructions, and make your lives and your pets’ lives easier by complying with your veterinarian’s instructions.

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.

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

Should You Believe That Article You Just Read?

September 9, 2017 by Nicole Palumbo, DVM

The Internet loves to sensationalize stories. It’s so easy to share these stories through Facebook and other social media platforms. It just takes one click and it is shared to friends and friends of friends and friends of their friends. It spreads like wildfire.

But here is the problem… is it true? How often are people actually reading and investigating how biased the article is before sharing it? When it comes to social media we all have to be careful with what we share and what we believe is to be true. Here are some guidelines to influence you on what is appropriate to share in regards to reporting on veterinary medicine.

If you read an article regarding a “horror story” about a veterinarian and an upset owner there are a few things to look for and analyze.  Does this article give information from the owner only? Is there a generic statement from the veterinary office? Does the veterinarian even make a statement? What type of medical information is given and are there sources? Many articles are biased towards the owners. Veterinarians ethically and legally cannot give out any information regarding a patient or owners of said patient.

When these types of articles are written, unless the owner gives permission for the veterinarian to share records, the owner can unfortunately sway the audience with their account and their knowledge of the medical issues. Many people who read these stories don’t have a lot of behind the scenes medical or veterinary experience so it makes to hard for people to understand what may have actually happened.

I have seen news articles with owners describing how the veterinarian killed their dog, which was in congestive heart failure, by administering oxygen. This is one of the number one things veterinarians do in a heart failure crisis but because the owner was so convincing with her story many people jumped on the bandwagon and started to harass the veterinary hospital.

This type of reporting does not help anyone get through the tough situation of an animal passing or dealing with a tough disease and this type of reporting is also very irresponsible. If there truly was an error that occurred then the owners should use proper channels and report it to the state board. It may seem like the easier and quicker way to get out their anger but biased articles never solve anything.

Other articles we see get passed around are “alternative” treatments for diseases.  There are many different pet-related websites and sometimes it is hard to weed out the bad ones. Always look at the website content first before sharing.

Does the person writing the article have any background in said disease? Are they a veterinarian, biologist, nutritionist, or technician? What references do they use? Are their references just links to someone else’s blogs or website or are there actual scientific articles?

Do they try to mislead you by saying that your veterinarian just wants to charge you lots of money for something you can treat yourself but then try to sell you their own products? These are red flags that should make you say, “No I am not sharing this and I will not trust this.”  By sharing these potentially dangerous sites you can put your animal and your friend’s animals at risk.

The last issue we see a lot is pet food articles. Many people are themselves trying to become healthier and thus want their 4-legged friends to also be healthier. Nutrition is a huge part of an animal’s health and unfortunately, there are a lot of opinions out there. There are articles that will be shared regarding raw diets only for dogs, which many breeders will push onto clients or the grain-free trend that pretty much plays on the gluten-free fad with people.

Are there some dogs that will do better on a grain-free diet or a raw diet? Of course! But do all dogs need to be on these diets? Not at all. The same idea goes for articles on certain brands of pet food that people deem “poison”. A few years back someone wrote an article about dogs that died and the owner blamed a specific brand of pet food. The article kept incorrectly stating that antifreeze was in the pet food and it killed thousands of dogs. The article spread quickly and many veterinarians were getting calls regarding the food several times daily.

The sad part is that all it took was a quick google search to realize that it wasn’t ethylene glycol (antifreeze) but propylene glycol (a preservative) that the article was referencing and this ingredient is in many foods that we eat daily. There was no story but many pet owners were distressed for months. The same rules apply as before- check your sources before spreading inaccuracies.

All in all, if you have questions, concerns, or just want to know where to get solid information regarding pet care please consult with your veterinary office. Many will give you a list of trusted websites, articles, and news sources that you can feel comfortable with. It’s so easy to share things online but remember that you could potentially harm your pet or even spread lies that can ruin a veterinarian’s career with just a click of a button. Take the time to investigate what you are sharing before passing it along.

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.

Filed Under: Blog Tagged With: Life With Clients

Why Veterinary Professionals Are Medical Professionals Too

June 24, 2017 by Nicole Palumbo, DVM

Recently I was part of an argument in a comments section on Facebook. I told myself not to get involved but after seeing so many veterinary technicians and veterinarians beaming with pride regarding our profession I couldn’t sit back and not defend my colleagues.

The medical community is vast- Human physicians, dentists, psychologists, pharmacists, nurses, biologists… and veterinarians, and veterinary technicians.  We fit in there too. But unfortunately, there are a lot of medical professionals that view us as less than because we work on animals and not humans. Our degrees aren’t equal for these people. They get upset when we try to equate the same tasks and jobs that veterinarians do to human physicians. Instead of understanding our job, they continue to ignore the parallels.  This creates a lot of issues in the medical community and makes veterinarians and technicians feel like second-class citizens.

In undergrad, I was tracking “Pre-Med.” I had a lot of classmates that were considering different careers- a few dentists, a pharmacist, and a few medical doctors.  Unfortunately, a few of those classmates made fun of my choice to apply for veterinary school. I got a lot of “you won’t even be a real doctor” and “that will be an easy job.” Even in undergrad, the misconceptions of what being a veterinarian was all about were vast.

Fast-forward to today where I still have to defend my choice and defend my veterinary technicians.  I am not trying to covet anyone’s job. I am not trying to make it seem like human physicians do not work hard. I am trying to show people how alike our fields are and that everyone deserves respect.  I am not going to get into the argument if veterinary technicians should be called nurses- in certain countries they are but in the U.S they are technicians. That isn’t what this article is about. What I do what to discuss is how alike our professions are without creating more animosity towards each other.

A veterinarian goes through 4 years of pre-med undergraduate school and then another 4 years of veterinary school. Every course that we take is exactly the same as our human counterparts but geared towards animals. Unfortunately instead of learning these courses for one species veterinarians have to learn it for all species. I wish I could say that a cat is similar to a small dog but I think all of my former professors would be fuming.

During our fourth year, we go through rotations that focus on surgery, internal medicine, oncology, etc. We prepare and study for the national board exam and then usually have to take a state board exam to get licensed.

As veterinarians, we are expected to be able to handle a variety of medical specialties in the course of a regular day. I can go from a puppy exam discussing early life nutrition, vaccinations, and care to an oncology appointment where I am discussing what types of chemotherapy might be best for lymphoma.  During that, I may get an emergency surgery presented where I have to stabilize the patient and prepare the owners for complications and issues with undergoing anesthesia.

We see similar metabolic diseases as our human counterparts and run the exact same types of tests to monitor and track these diseases. Just because we work on animals doesn’t make our jobs any less important and any less different than human physicians.

A veterinary technician goes through a similar path. They go through schooling learning microbiology and other similar courses as nurses do. Although they obtain an associate’s degree their job parallels the work of human nurses. A veterinary technician is the one who is your pet’s advocate. They place IV catheters in hissing cats and then have to read fecal samples, blood smears, and skin scrapes.

Veterinary technicians are the ones monitoring your patient under anesthetic and have a vast amount of knowledge in anesthesia, radiology, and internal medicine. They are crucial to the veterinary field, just like nurses, and deserve to be acknowledged for their skills.

Maybe you don’t value an animal’s life and thus don’t value the work that a veterinarian and their technicians accomplish daily. Maybe even after explaining how our training is exactly alike you still don’t think that the professions are the same.  What I suggest is to walk a day or a week or a month in the shoes of a veterinarian and a technician. Ask if you can shadow a busy veterinary hospital and see for yourself.  Don’t ignore another profession because you don’t understand it.

The world is full of misunderstandings and hatred because we choose to stay in our bubble and not experience others’ experiences. I love my human counterparts and nurses – I know how hard they work and the daily tasks they have to endure. I hope eventually we receive that same respect.

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.

Filed Under: Blog Tagged With: Medicine, Perspective

10 Wrong Things Pet Owners Say About My Salary

June 6, 2017 by Nicole Palumbo, DVM

“I bet I paid for this exam room.”

“That’s a nice wedding ring, bet my dog’s bills paid for that.”

“I bet you live in a giant mansion with all the money you have made off my cat.”

“I put your kids through college.”

“I paid for all those cruise vacations.”

“Is that your Lexus that I just parked next to?”

“Vet bills weren’t so high until vets decided they needed to drive Mercedes and live in gated communities.”

“ You probably buy a new car every month.”

“I’ll bet you had a good Christmas after doing my dog’s surgery.”

“Well I guess the kids won’t get Christmas gifts this year. Hope you enjoy yours!”

All of these are real quotes stated by real owners.

Veterinarians are doctors. Let’s repeat that, we are DOCTORS! We have gone through the same training and dedicated our lives to the same level of medicine as our human counterparts. But when it comes to respect and wages, we seem to be stuck.  Most people see human doctors as deserving of their large wages, nice cars, and expensive houses. It’s a mark of a good human doctor to have it all. It’s accepted that our human counterparts make good money and deserve it. So why are veterinarians consistently made to feel bad if they make a living wage?

We are not rich.  Veterinarians make between $50-80k per year depending on experience and area of practice. Sometimes specialists will make a good amount more than that. But compared to human physicians we make about 1/3- 2/3  of their annual salary.  We put the same amount of time and studying into our degree but at this time our wages do not reflect it.  Next time you tell a veterinarian that they are just in it for the money just remember that with our wages there is no way your statement could be true.

Another misconception is that for every test we suggest we are making extra money off of your animal. We aren’t!  Most of us work on a salary. Some get bonus money depending on if we had a good month but no veterinarian is suggesting blood work or x-rays on your animal to make 100 bucks extra that month. We suggest those things because your pet is sick and we want to figure out what is wrong with it.

The same idea goes for recommending a specialty diet or a specific medication. We do not get paid by pet food companies or drug representatives to push certain products. We will occasionally get free click pens or a “lunch and learn” to discuss new products, but let me tell you, a free pen and a slice of pizza aren’t going to sway me to push a product. In fact, most veterinarians will try to find substitute medications or script out products if they are cheaper at an outside pharmacy. We want your pet to get better, not for you to have to struggle with paying its bills.

Another issue is the price of veterinary care depends on the region. The care may be the same but unfortunately, the cost of living and keeping a veterinary clinic afloat does differ whether you are in a rural area or a large city. We aren’t ripping you off when the big city vet costs twice as the rural vet- we are just trying to pay our staff, keep the lights on, and also make a living ourselves.

Speaking of making a living for ourselves, we shouldn’t have to feel bad if we do have a nice car, or a large house, or a beautiful engagement ring. Most of the time those nice things aren’t because of our wages but most likely the wages of our significant other. You see us veterinarians make very little and graduate with large amounts of debt. Most of us are paying 2000-3500k per month in student loans. Due to this we usually are driving old cars, renting our houses, and buying ramen noodles to survive.  If we do make a little extra because we kicked butt during a specific month and we get some bonus money, why can’t we celebrate that accomplishment without clients thinking we are “all about the money?”

It is truly a catch 22-type situation. We are proud of what we do, just like our human counterparts, but we are constantly told we just want money to pay for our expensive lifestyle and veterinary practice.  The misconceptions are many and when we try to explain the reality we are shut down.  Honestly though, do you think it’s okay to make the comments stated above towards anyone at their place of work?  Maybe that is a whole other subject entirely….

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.

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

The Sad Truth About How Much I Care

April 25, 2017 by Nicole Palumbo, DVM

I’m full of compassion. It hurts. It truly hurts. I’m not running out of it. I’m not failing to care about my job but I am running out of patience for people who should care and they don’t.

As veterinarians, we constantly get told, “If you cared about my pet you would do it for free.” If you cared about my animal then you would figure out what is wrong with them. If you cared! If you cared! I do care and I want to help your pet, but I can’t be the only one in this equation. Owners need to care as well, not project their anger onto us.  Day after day the same situation consistently occurs and it is causing many veterinarians to become depressed and even hate their jobs.  We have compassion, the owners don’t.

I saw a young dog the other day with a history of limping for four weeks. The dog was happy but obviously not using its front right leg.  It was swollen and painful to the touch. The owners kept trying to convince me that the dog wasn’t painful. I had to convince them that the reason it isn’t walking on the leg is because it hurts.  I wanted to sedate the dog, feel the leg under sedation, and take some radiographs to make sure we didn’t have a fracture. The owners declined everything and almost left without pain medication. They told me if I cared then I would have reduced the cost to “fix” the problem. I wanted to help the dog but the owners didn’t care enough to let me.

A few days before that I saw a cat that had been acting lethargic. It was an indoor/outdoor cat. The first thing I noticed was that the cat was covered in flea dirt, fleas, and its gums were pale white. The owner allowed me to do some blood work to confirm anemia but then refused to let me treat the cat. “You want me to put those chemicals on my cat! It’s going to kill him!” The fleas were killing the cat and they need to be dealt with. This is fixable and preventable!  She left with the cat. We found out a few days later that the cat died. I could have saved the cat. I wanted to save the cat. I cared about that cat. The owner did not.

Yesterday I saw a dog that we had seen multiple times for the same issue. The dog gets infected with whipworms, it starts having awful diarrhea and weight loss, and eventually, the owner brings it in for us to treat it. Usually by the time he brings the dog in it is on death’s door and needs to stay in hospital on IV fluids and de-worming medication. The owner refuses to put the dog on a monthly parasite prevention medication because he thinks we just want more money from him. So yearly, like clockwork, the dog comes in for treatment and then goes home to get re-infested. I care about this dog. I don’t want this dog to continue to get sick. But the owner doesn’t care.

Day after day cases like this come in. People who don’t understand often say veterinarians need to stop complaining about their jobs. It’s our JOB to work with animals. Yes, that is true, but it shouldn’t be my job to care more about your pet than you do. I will continue to care though because I have a lot of compassion and it’s not running out despite what the definition of compassion fatigue states. But I am growing increasingly depressed with humans and their lack of compassion. I will never blame the animals, for they are just innocent bystanders.  I am not sick of caring, just sick of caring more than other people.

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.

Filed Under: Blog

Should Low Cost Spay/Neuter Clinics Require Proof of Hardship?

March 4, 2017 by Nicole Palumbo, DVM

Every town has one, sometimes two, low-cost spay/neuter clinics. These clinics do amazing work with the short amount of time they are open to the public. Most stock themselves with volunteers who work long hours and do not get paid for their time. The veterinarians they acquire may also be volunteers or make very little for their work. These people do not do it for the money, but to help people and animals in need.

Spay/neuter clinics often are financed by donations from the community and different organizations. Hospitals donate supplies, surgical equipment, etc. And again people volunteer their time and sometimes money to help with the process. All in all, spay/neuter clinics are great for people who have animals but they cannot afford the price of a regular veterinarian. Luckily many people who adopt from shelters or rescues obtain animals that have been already spayed/neutered, either through the local shelter or spay/neuter clinics.

This helps relieve the burden of financial responsibility from people who want a companion animal but may not have the time or finances to get them fixed.  But for those who find, acquire from a friend, rescue young, or just plain forgot to get their animals fixed and are financially strapped- spay/neuter clinics are a great option for them. But here in lies the dilemma.

I work at a small animal clinic and often see a lot of great people adopting from local shelters and rescues. But there are a lot of people who acquire their pets from local breeders and pet stores. These animals typically do not come to them spayed/neutered because they are too young.  Many of these animals are purebred and cost anywhere between 500-3000 dollars depending on the breeder or pet store. These people spend a lot of money on these animals yet I often hear them stating they will not be using my services for spay/neuter. These people state that they will be using the local spay/neuter clinic because they are cheaper. Although there aren’t any rules against this, it does create an issue.

Spay/neuter clinics have reduced prices because they run on donated money and time. For someone who can easily afford a 3000-dollar pet using a spay/neuter clinic can be considered stealing from charity. Some of those people may argue that they feel their own veterinarian is ripping them off with higher costs so it’s better to just use a low-cost spay/neuter clinic. Others will argue that someone who can afford a purebred animal should not take away a spot meant to be for a low-income family.

So what do we do? In the human medical field, you have to prove financial hardship to have medical bills reduced or nullified.  Do spay/neuter clinics need to start asking for financial proof before allowing someone to bring their pet in? Do we rely on looks alone, knowing that is just stereotyping people? Do we hope that people are being honest when they bring in their animals for these procedures?

In my opinion, it’s a matter of educating the public. No, we don’t need people to prove they are poor. But we as veterinarians need to start educating owners about spay/neuter clinics and what they should be used for.  When you have clients discussing taking their 3000 dollar French bulldog to the local clinic- don’t scold them but educate them on why those clinics are cheaper and that they are supposed to help benefit people who cannot afford a regular veterinarian. Those clinics are not to be taken advantage of and should be used for people with financial hardships.

It’s a complicated issue… what is your opinion?

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.

Filed Under: Blog

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