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There I Said It

There, I Said It: Your Medical Records Stink

February 18, 2016 by Anonymous

Welcome to There, I Said It- a column where we give you, the reader, a chance to get something off your chest in an anonymous fashion. Be it embarrassing, frustrating, or just something you didn’t want to admit out loud, it still might make someone else having a bad day feel just a bit better. If you have a story of your own, unburden yourself at TISI@drandyroark.com.

“Your medical records stink.”

Yep, I just said that. Right now you may be thinking, “Who is this person and where do they get off being so self-righteous?” Well, have I got news for you. If you are the one thinking these things, then your medical records probably do stink.

You know who you are. You are the one that is two weeks behind on medical records and somehow has the uncanny ability to extract from the nether regions of your brain accurate details of each pet’s comprehensive exam. You are the one that writes a two line history for a pet that presents for vomiting and lethargy for a week. Or maybe you are the one that frequently uses “PE = WNL” for the main body of your medical record.

[tweetthis]If you are the one thinking these things, then your medical records probably do stink.[/tweetthis]

By now, some of you are rolling with laughter and others are just rolling their eyes. You’re part of the problem too, even if you are one who does it right. This type of medical record keeping is so common that everyone shrugs it off. How many times have you been to a veterinary conference and people joke about medical record keeping when really it is not that funny? It is actually shameful.

Think about this for a moment. Everyone learned proper medical record writing in veterinary school. The state VMAs have been recommending and in some cases borderline begging us for almost two decades to put more effort into our medical records and have pretty much waved the white flag.

Businessman Preparing Checklist

Uh oh, I know what’s coming. I just heard someone use the most common excuses: “We are still much better than the human side”, “My boss complains that I take too much time”, “I do not get paid enough to stay and finish my records”, or “I am the only one that is ever going to read it”. Any of those sound familiar? They probably do.

So, who is to blame? You are. I am. We all are. Why? Because as individuals, we should have enough pride in our education and skill set to strive to maintain a higher written standard. Because as business managers and owners, we should have enough intestinal fortitude to enforce a standard and lead by example. Because as veterinary medical governing bodies, we should hold businesses and individuals accountable for egregious medical record keeping.

It would not be fair to end this editorial without proposing some solutions. If you are an individual that truly believes in writing thorough medical records and maintaining a standard, do not sacrifice your ethics for others. Ask for time to finish your medical records during your shift. Ask for more “warm bodies” so you can spend less time “doc-teching” and more time completing your medical records. This isn’t a luxury, it’s a necessity.

If you are a business manager or owner, you need to have enough respect for medical record standards to enforce them with your veterinarians and hold them accountable. Value your doctors enough to provide them with sufficient staff for them to be able to spend more time on their medical records. Recognize that you may need to sacrifice on your bottom line in order to hire another doctor to create more time for all your doctors to be able to finish their medical records without each one working 60 hour weeks in four days. And, if you are part of a veterinary governing body, please start holding accountable those who blatantly disregard the written standards of our profession. Our integrity depends on it.

[tweetthis]We should have enough pride in our education and skill set to maintain a higher written standard.[/tweetthis]
TISI bannerThe views and opinions featured on There, I Said It are those of the authors and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Filed Under: Blog Tagged With: There I Said It, Vet Tech Life

There, I Said It: I’m an Abused Intern

January 28, 2016 by Anonymous

Welcome to There, I Said It- a column where we give you, the reader, a chance to get something off your chest in an anonymous fashion. Be it embarrassing, frustrating, or just something you didn’t want to admit out loud, it still might make someone else having a bad day feel just a bit better. If you have a story of your own, unburden yourself at TISI@drandyroark.com.

By Anonymous

I’m an intern. And somehow, I enjoy what I do (nearly) every day. However, I fail to see why we interns (and residents too) as a whole are, well, abused, for lack of a better term.

I’m not beaten or bullied by any means. In fact, everyone here is actually really nice and helpful. But I make very little money compared to the time and effort spent in the hospital. I’d make more money doing just about anything else – seriously, anything – when you consider a little thing called minimum wage. How is this ok?

We treat our newest members of the profession in a way designed to make life miserable. Everyone tells me, “Oh, internships suck,” And, “You get paid in knowledge.” Unfortunately, I can’t use my knowledge to buy new scrubs… or dinner.

[tweetthis]We treat our newest members of the profession in a way designed to make life miserable.[/tweetthis]

A Recent Example

I do get “extra” pay for emergencies I see, unless the client doesn’t pay the bill, in which case I get nothing. This happened just the other night, in fact, and instead of the hospital saying, “This shouldn’t have happened, and it’s not your fault the receptionist didn’t tell the guy about the emergency fee. Here’s your 10 bucks,” (and yes, that’s my “extra” pay per case: $10), I was told I won’t get it because, “That’s part of your clinical training.”

So, I have zero supervisory responsibility over the staff, and yet I get penalized for a mistake they’ve made. That’s pretty fair, right?

Oh wait, it’s not.

No, Really. Why?

Veterinarian doctor making a checkup of a cute beautiful catWhy do we allow this? The answers always seem to be along the lines of: “Because I went through it, and you have to do it to,” and, “Well, interns at xxx have it twice as bad.” Those don’t seem like the kind of logical, ethical answers I’d expect from someone in our profession, but it’s what I hear every single time.

I don’t need (or expect) to live like a king by any means. However, literally scavenging about 80% of my caloric intake from hospital/vet school leftovers laying around after talks, CE courses, etc. is part of my daily life. At least my scavenging allows me to save my pittance to buy a car… Hey, a man can dream!

There Has to Be a Better Way

I don’t expect a massive upheaval by writing this. I worked in academia for a long time prior to, and during, vet school. I know there are lots of money issues, budget cuts, etc. However, when minimum wage sounds like a huge promotion, it’s hard not to think, “Maybe I made the wrong choice.”

I’m not quitting my job anytime soon, nor am I considering doing anything terrible to myself. I’m actually pretty happy right now, and am glad I’m in this program. But I think it’s important to note there are serious problems within our system, and I truly believe there is a better way than the current model.

I will end by saying this: I don’t think people running programs are inherently evil slave-driving scoundrels. But you can be very sure I won’t repeat the cycle, should I ever have interns/residents under me. They will at least be able to live without worrying about if there will be free food in the building that day because they haven’t eaten in two days*.

[tweetthis]There are problems within our system, and I believe there is a better way than the current model.[/tweetthis]

*That particular event only occurred once, near the start of my internship. I had just moved back from Australia, had no money, and had only been paid for part of the first month (and every cent went to paying the rent). But does this sort of thing need to happen at all? I think we can come up with a better solution.

TISI banner

The views and opinions featured on There, I Said It are those of the authors and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Filed Under: Blog Tagged With: Perspective, There I Said It

Why We Fail Pets When We Judge Pet Owners

July 18, 2015 by Dr. Andy Roark Community

Years ago, I worked for a small animal clinic in Fleming Island, Florida. The area was becoming more developed, but there was still a lot of rural area around, with a majority of old country folks living there. Our clinic saw mostly dogs and cats, with birds and exotics making up the balance.

One day, an older lady showed up without an appointment. To all appearances, this lady didn’t have two pennies to rub together. Mrs. Strange was thin, with much-worn clothes and the sallow complexion of a lifelong smoker. The dog with her wasn’t much better off. The older black pit bull, Coal, was emaciated but with a swollen, pendulous belly and a wicked cough. It was clear, however, that she loved this dog with all her heart.

Coal was Mrs. Strange’s companion and protector while her husband drove a long-haul tractor trailer for days or even weeks at a time. The dog had even kept Mr. Strange from entering his own home one late night when he returned home from a run a few days early. Not until he reassured the dog, ‘Coal, it’s Daddy,” was the gentleman of the house allowed in.

Coal was somewhere around ten years old, and had never been on heartworm preventative. As a matter of fact, he hadn’t been seen by a vet since he was a puppy.

Certain that most of the diagnostics I offered would be refused, I was mildly surprised when Mrs. Strange agreed to blood work and a heartworm test. Unfortunately, we didn’t get as far as the ELISA test; a direct smear revealed more microfilaria (heartworm larvae) than red blood cells. And, just in case there was any doubt, Coal coughed up an adult heartworm onto the exam room floor. Clearly, the prognosis was bad.

Dr. Mike Ricker explained everything to Mrs. Strange and she opted to take him home and think about what to do. In as poor a condition as this dog was, treatment might even prove fatal. We offered to refer them to the University for a modified treatment that might be less stressful thinking anything we could do to help this poor, sick dog should be discussed.

Mrs. Strange’s husband was due home; She wanted him to be a part of the decision. We sent her home with medication to make Coal more comfortable, and she paid her bill in full with cash. We honestly didn’t expect to hear from them again, except perhaps to be told that Coal had died on his own.

The next day they called and scheduled euthanasia. Mrs. Strange and her husband came at midday with Coal. Mr Strange looked much like one would expect a long-haul trucker to look; long grey hair, ball cap, worn and faded jeans and a t-shirt advertising a far-away truck stop. We spent a surprising lunch hour laughing and crying along with them while they said goodbye to their Coal. Once again, they paid their bill in cash and took Coal to bury him at the only home he’d known.

Once more, we never expected to see them again.

In areas with rural residents who are used to doing for themselves, it’s not uncommon to have pets brought in at death’s door. The owners often hope we can work some kind of miracle to snatch their pet from the brink. They feed their dogs table scraps and Old Roy, get their vaccines from the feed store, and do their doctoring at home. Only when something is beyond their abilities do they seek help. Educating these people out of their self-sufficient mindset seems practically impossible.

Two days after Coal’s passing, Mr. and Mrs. Strange called to make an appointment for a new puppy. They came that very afternoon with the most beautiful red-nosed pit bull puppy I’d ever seen. Her name was Ruby and we all fell in love with her. No one was more smitten than her proud new parents.

We were told they wanted to do everything right by this dog. Ruby wanted for nothing; she was fully vaccinated and promptly started on heartworm preventative. Ruby’s owners followed our instructions to the letter, always grateful and appreciative of our help.

Over the next year, they presented us with two more red-nosed additions to their family. Both of them were accorded the same complete and loving care as Ruby. Mr. and Mrs. Strange became some of our favorite clients, and I looked forward to their visits.

Most of all, these people taught me a valuable lesson. Appearances are deceiving, sometimes in a good way. If we had all assumed that they were (and treated them like) uncaring pet caretakers because of their first dog’s condition, I’m willing to bet they never would have come back.

Never assume you know someone’s story just because of how they look or act. Coal may have been a medical nightmare, but he was loved. The feelings his owners had for him ensured his successors were the most pampered, healthiest and happiest dogs I’ve ever known. I was, and still am, grateful for the lesson.

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.


Debi Matlack

Debi Matlack is that rarest of creatures, a native-born Floridian. She still lives there with her husband, another Native Floridian, and four cats. She hopes that someday her writing might prove popular enough to support her in the manner to which she would like to become accustomed, probably becoming a crazy cat lady (but a well-financed one).

You can find Debi’s recent novel Old Dogs for sale here.

Filed Under: Blog Tagged With: Life With Clients, There I Said It

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