Perspective

Okay, okay… I know. We are supposed to charge for our time. I am a huge advocate for charging appropriately for all our hard work. I am a dentist/oral surgeon, after all. As a group, we all need to recognize extraction of a canine tooth is worth more than 25 bucks.

But, I will admit, I make a hypocrite of myself when it comes to my own recheck exams. Whenever I perform any dental care or surgery that involves an incision, extraction, or -ectomy, I ask the family to please come back and see me two weeks later for a free recheck exam. And nope, I do not secretly wrap the cost into the surgical price somehow, it is genuinely free. No dinero necessary.

From a strictly marketing standpoint, you could argue this is a value-added service. An opportunity to show the client we genuinely care about their pet’s wellbeing and ensure their beloved four-legged friend is doing well. From a patient care standpoint, certainly we want to be sure the mouth has healed, and our little furry beasts are eating, playing, and being exactly the mischief maker they are destined to be (with a comfy, healthy mouth to boot). You could argue this is my opportunity to reinforce the concepts of oral health, provide resources regarding home dental care, or reinforce the importance of an annual cleaning. And I suppose, all of these benefits are true. But, if I am honest, that is not my real motivation.

Here is the kicker. I could bet that 99 out of 100 post-operative patients I see are going to be beautifully healed at the time of their recheck exam and Rover likely did not miss a beat. If we are playing a statistics game, I am definitively wasting a clients’ time to herd their pet into a carrier, drive through morning traffic, and people watch in our lobby waiting for me to come and take a peek. Let’s face the tooth (get it? that’s a stupid dentist joke), their little shih tzu’s mouth is going to look great.

The truth is, my recheck exam is for ME. It is my opportunity to simply sit back and listen to the warm fuzzies. In those moments when I trap a family into an exam room two weeks following my care, I relish the story about how Maverick the weiner dog found his old rope toy even though he is toothless. I soak up the tale of how Snowbank stopped hiding in the leftover Amazon box that had become his home these last few years. I savor the adventures of cutie patootey Lucy who can finally ride between Grandma and Grandpa in the front of the RV again because that trench mouth stink is gone.

My heart fills when Tank’s wiggly butt tries so hard to sit on my lap.

Goosebumps swell as I literally stand in the doorway watching Drake pull his family’s arm off while heading out the front door.

Tears well when a family stops to hug me and say thank you.

How many of the good cases do we all remember? Few. But I bet you can name the last patient that passed away in your care. We need to fill our buckets with the love that is easily shared with us if we just take the time to listen. We need to hear the beauty of what we do and let it seep down into our soul… go ahead… trap your families in an exam room… pause and listen.

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.

ABOUT THE AUTHOR

Dr. Donnell Hansen is a board certified veterinary dentist and oral surgeon from the Minnesota BluePearl Hospitals.

A Minnesota native, Donnell went to school at Luther College, graduated veterinary college at the U of MN, and spent a year in Stillwater, Oklahoma for her internship before returning home for a residency at the University of Minnesota. In 2009, Dr. Hansen joined forces with friends to form Moxie Center, which is now known as BluePearl Veterinary Partners.

While managing a busy clinical caseload, Dr. Hansen also speaks nationally about the value (both from a patient care standpoint and practice health perspective) of veterinary dentistry and oral surgery. Dr. Hansen has a special interest in maxillofacial surgery but honestly, loves the whole gig.

To provide a little balance to life, Donnell enjoys time with her family, including her husband (a fellow veterinarian) and two children, out on Minnesota’s 10,000 lakes or working a jigsaw puzzle during the long Minnesota winters. Like any veterinary family, there are an amalgamation of pets at home but the beloved include her pocket pittie, names Crickett and a beast of a labrador named Goose (or depending on the day, Goosifer).  There may or may not be a bunch of bull head eggs hatching in her daughter’s aquarium.

Every year at my week-long quilt retreat, I meet up with friends and indulge in my favorite pastime. Even though I am a doctor, and you’d think nothing about quilting could be scary, there are things I’m reluctant to try. Appliqué (APP-lik-ay) was one of those things. I had made a star quilt for a friend’s baby, and because of a mistake in the instructions, it couldn’t be sewn together with squares at the corners to make a quilt top. I asked one of our more experienced quilters for help.

Martha is a retired teacher, and she is brilliant at explaining things in a non-intimidating way. She suggested I appliqué the piece onto a large square of fabric, thereby removing the problem of the not-quite-90-degree angles. I hemmed and hawed. I wasn’t really looking to try something new.

“Come here, Darlin’,” she said in her no-nonsense tone. “Let’s get this done.”

She walked me through the process. She was always there to answer questions when I was stuck. She never made me feel stupid or like I was bothering her.

That’s the kind of teacher I try to be.

I don’t know what makes people think that the best way to teach someone is to humiliate and insult them. I can’t fathom why we want students to absorb something and determine that the most prudent course of action is to make sure they are sleep deprived before imparting information. The most common “reason” I hear is “that’s how I had to learn it.” If only I could cough and say the word bullshit at the same time in writing.

I talked to a vet student from Iowa State this week, and we found we had the same passion – wellness for students. Obviously, it would be easier if we could start wellness as children, but if we can’t, then starting with future vets and techs is the next best thing. I know that school is hard (I’ve been there), but there are things we can do to make learning better and help us turn out resilient, healthy students. If we are turning out brand new veterinary professionals that are already riddled with burnout and compassion fatigue, why are we congratulating ourselves?

I’m not suggesting trophies for everyone or not using red pen so as to preserve everyone’s feelings. I’m saying that we need to provide support while having the goal to turn out self-sufficient, confident veterinarians and technicians who either know the answers or know how to find them.

The professors, staff, and students in school who bully and torment others are not a secret. EVERYONE knows. When I was in school, there was a professor who picked a favorite and least favorite student and proceeded to lift them up and stomp on them, respectively. And we were warned ahead of time that this would absolutely happen. That kind of crap needs to stop freakin’ yesterday.

Are we professionals, or are we a fraternity running a hazing? You know how everyone freaks out and destroys campus groups when they do something stupid that results in a death? Maybe we need to look at school the same way. Veterinary professionals are contemplating and dying by suicide at an alarming rate. We need to make sure that as teachers, we aren’t contributing to the problem.

It is said that we learn the most from failure. This is true. How we learn and recover from failure is directly related to how we and those around us react. If shame comes from within (as it always does) AND without, then we don’t have a hope of recovering in a positive way. For instance, I once attempted to spay a male cat. When I discovered the mistake, I went to my boss in tears. He chuckled and said, “If you haven’t tried to spay a male cat, then you’re either new to this or lying.” Then he sat down with me and we created a protocol to ensure this never happened again.

He emphasized that while it was also my job to check, the staff had missed this, as well. He also walked me through what to say to the owner and was nearby while I called and spoke to him. Had he yelled at me or written me up, I probably would have been too afraid to attempt surgery again for a long time.

Some lessons have to be harsh so they are taken seriously. But vet medicine has a natural harshness built in: if we screw up, our patients may die. That should be the hardest lesson we have to learn – and every single one of us will learn it the hard way.

Congratulations to the schools making wellness a priority. Thank you for putting your students first. Thank you for remembering these students are, in fact, your customers. They are paying you large amounts of money (in some cases hundreds of thousands of dollars) and treating them like dirt shouldn’t be an option. In fact, I’m guessing if they aren’t left with scars from your school, you might actually get a donation from them when you come asking.

I’m challenging everyone who teaches to decide what kind of teacher they want to be. Will you leave impressions or scars? Will you build up or tear down? Will you be remembered with gratitude or as a traumatic experience? The choice is yours, and I hope you make the right one.

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.

James was my heart kitty. He was like a little person. He had stress-induced asthma and I used to sing to him (“Sweet Baby James”) in the car – when we drove cross-country from California, where he was born in an old church, or when I had to take him to the emergency clinic in the middle of the night to get him on oxygen. He saw me through five moves, my vet school graduation, my bad-idea boyfriends and my marriage. He knew the ins and outs of my moods and never loved me any less for one second, even when I got a dog.

 
An Old, Loved Carrier

 
Through all of this, there were few constants other than love, his affinity for chewing around the edges of plastic shower curtains, and… the cat carriers. Green plastic, the kind that open at the top as well as the front, but the handles cut into your hand when the rubber grips wear off. They sat in the study at my Dad’s house in Maryland, the living room in my one-bedroom apartment in Ithaca, my townhouse in Syracuse, and in the “cat rooms” at our houses in Pennsylvania. No matter where we lived, there they were, with old hairy towels at the bottom in any room where my cats liked to hang out. They used them as beds, they played footsie through them, and they left snack crumbs in them. Sometimes, they had to go to the clinic in them, but by then the cats and the carriers were old friends.

In the winter of 2015, James went into heart failure. He spent four days at the ER and came home to me for one night, held together by a whole bunch of medication and my desperate hope. I got up the next morning and found him gasping for air, unable to eat, looking at me with liquid eyes that asked for peace. He was in his carrier, sitting on his old hairy towel. I closed the door, put on my coat, and sang his song to him all the way back to the ER for the last time.

We hear it all the time: we live in the age of instant gratification. We have access to more information than we could ever hope to need about any subject we could possibly think up. We have drive-through coffee and order-ahead food apps and movie streaming and digital books and online bill-pay. We can renew our auto registration or pay the mortgage on the day they’re due. Somehow, even though we can get so many things done instantly, we have less time than ever before. And this makes the truth hard to swallow: in this era where you can have no cash on you and use an app to find a ride from a stranger in five minutes or less on Saturday night in a major city, some of the best things in life still take time – sometimes a LOT of time.

I schlepped those cat carriers across the country and up and down the East Coast, and I rarely cleaned them out because my cats loved the smelly old towels and were suspicious of new ones. They looked terrible and they weren’t even comfortable to carry. But knowing I didn’t have to stuff my terrified, gravely ill, once-in-a-lifetime kitty in a box he hated on the last day of his life? That was priceless. It literally took years and it was worth it.
 

The Long Game in Life

 
Bill Dellinger said, “Good things come slow, especially in distance running.” He might as well have said, “… in crate training,” “… in medicine,” or “… in relationships.” I heard a podcast a while back where two running coaches were discussing what kinds of clients they like to take on. They said the biggest thing for them that determined whether a runner would be successful was whether the person was looking for rapid progress or in it for the long game. A runner who entered the program knowing they would be working hard for 18 months or more before really expecting to try to achieve a big goal was already demonstrating the keys to most great things in life – dedication and patience.

But we don’t admit this enough. When we start a new job, we feel like we have to gel with the team immediately. We might feel lonely because no one really knows who we are, and it feels like they never will. Even if we left a job we knew wasn’t the right fit anymore, we think nostalgically about our former coworkers who really “got us,” forgetting that they had the benefit of many hours spent together in the trenches.
 

Clients Forget This Too

 
When we meet a client, there’s instant pressure to show them we are the best they’ve ever met and to convince them we know the right way for them to spend their money and emotional energy to keep their pet healthy. When we take on a project such as implementing the Fear Free initiative at our practice or trying to get clients and staff to embrace our message and culture, we are looking for immediate improvements in patient care, client perception and education, and staff happiness. These goals simply aren’t realistic, and yet we are surprised every day when we appear to fail.

I talk to clients every day about getting cats used to carriers, about conditioning their dogs to love the car, about the lifelong struggle that is allergic skin disease, and about planning ahead for things like flea season, emergency surgery, chronic disease, and possible weight gain after spay or neuter. I wonder if I often avoid direct references to the passage of time. People don’t seem to want to hear about that.

They want to know whether they will see relief for their pet in 24 to 48 hours, not hear that they will need to do a 12 week food trial with an elimination diet to try to avoid years of unnecessary medication. They want a guarantee of excellent behavior after one session with a trainer, not a link to videos about how to train your dog to allow his nails to be trimmed using positive reinforcement and about a metric ton of patience. And we can’t blame them at all, because this is what we want too. We just know better when it comes to our area of expertise.

Next time you feel the urge to roll your eyes as a client asks, “Why does her ear infection keep coming back? We can’t keep spending all this money for you not to fix it,” remember that client probably has 20 apps on her phone that let her get groceries ordered, bills paid, and trips scheduled faster than it takes you to figure out how to put a cat carrier back together.  Maybe, without condescension, find gentle words to remind her that anything really meaningful – like a pain-free, comfortable life for the Cockapoo whom she loves like a child – is worth the time and effort it takes to get it done right.

In the one-click age of Amazon Prime, sometimes the most revolutionary thing we can do is play the long game.

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.

About the Author

Dr. Katie Berlin is a small animal general practitioner in Mechanicsburg, PA. She is also a reader, a rider, a runner, a lifter, a teacher, and an art lover. She graduated from Williams College in 2000 with a degree in Art History and worked in art museums before going back to school and earning her DVM from Cornell in 2009. She is an avid supporter of Fear Free practice and the battle against compassion fatigue in the veterinary profession.