At SEVA GRREAT, we take the health and well-being of our dogs
very seriously, and our relationships with our veterinary partners is a crucial
part of our work. We are incredibly fortunate to have access to amazing expertise,
coupled with boundless compassion in our veterinarians and in all the members
of the veterinary teams with whom we work. This skill and talent ranges from
the front desk staff all the way to the veterinary techs, assistants, and kennel
attendants. We could not be more grateful for what they do for our dogs and for
the humans who care about them.
My title for this entry may seem a bit apocalyptic. But in
just the last few weeks, I have read or personally experienced multiple public announcements or other communication from veterinary practices about the extreme stress they are experiencing and
pleas for people to be understanding and respectful. This is showing up in the
veterinary literature I follow as well, and it makes me wonder if my title really
is that far-fetched. We are all experiencing longer delays for appointments, reduced
access to urgent care, and much busier veterinary settings overall. Emergency rooms are turning away cases that might have been seen just a few
years ago. Veterinary hospitals and emergency facilities are having to make
some difficult decisions to prioritize care to make sure those in greatest need
are seen quickly. That means some others will have to wait longer than what has
been the case previously.
No doubt some of the challenges are due to the changes that
practices had to make to keep open and to ensure the safety of all the people
and animals they encounter. Maintaining the high standard of care that our
veterinarians provide is taking a little longer these days, and the demand for
care has skyrocketed. As the stress and demands on these professionals have increased,
some practices are making changes just to maintain the ability of the staff to
keep functioning at such a high level. Some
clinics have reduced hours or have a time of shutdown during the day to enable everyone
at the clinic to catch up on work. Some have days during which they close
completely. Several of the emergency clinics we rely on have reduced hours or
had complete shutdowns for a brief time, reducing access to care and obviously
shifting the load to other facilities that are already operating at capacity. Staff turnover has been high in a field that
already had challenges hiring well prepared personnel, and it is not uncommon
at some clinics to encounter many new personnel on the administrative side and
often with the animal care side as well.
Add to the challenges the context of longstanding and under-recognized
comparatively high rate of suicide among veterinarians. (See link to Not One More Vet at the end of
this entry.) I am hearing repeatedly, from a number of sources, that the stress
and emotional demand on veterinary staff that has always been there is getting
much worse.
What makes me most heartsick about this scenario, however, is the veterinary staff who report being routinely subjected to rude, hostile, demeaning, and sometimes threatening behavior by the people with whom they interact. Perhaps it is only a small percentage of people who behave that way. But it cuts deeply, and it leaves a lasting impression. As more than one clinic staff has reported, it may be just a few, but those are the ones you remember until you just don’t want to do it any longer.
Big deal. We’re all stressed, you might think. We’re all struggling so what is the problem? Veterinarians surely are used to the stress and demands of the work. Many come to their positions through a long history of animal care, often starting as veterinary assistants in a practice. (One of the articles linked at the end of this post does an excellent job capturing some of the common themes in the life of a veterinarian.) But they are not used to the level of hostility and rude behavior they now encounter on such a frequent basis. No one should have to become used to that. I have heard stories of people being threatened, arguments over costs and a client being willing to pay only a portion because that’s “all the service is worth.” There are stories of name calling and insults I won’t print here. It has gotten so bad that some have had to shut down practices for a time or, at minimum, adjust work hours in order to take care of themselves. Research consistently has shown that when people are stressed and overloaded, performance suffers and mistakes can be made. Add hostility and name calling to the regular stress of the work and who can blame them for some of the changes they are instituting to protect themselves and the quality of the care they provide. Thank goodness it is likely only a few people who behave this way, but even that is too many.
But that can leave us feeling frustrated that we do not have
the access to which we are accustomed, and it is frightening to think about
what you would do if there were a true emergency and your nearest animal
hospital is closed for a week because they had to restructure to keep working
in this challenging environment. Even dealing with doggie diarrhea for an extra
few days while you wait for an appointment can be distressing for you and your
dog. So what are we supposed to do?
We can do a lot! We are facing a compelling, perhaps
necessary, occasion to rethink our relationships and our expectations of our
vets and also to improve our own ability to manage the health of our pets. While
we might resent how things are, I prefer to see it as an opportunity for transformation
that can improve the care of our dogs and our roles as their human caregivers. I
asked a number of veterinary personnel for their suggestions given how things
are these days and want to share those here, along with some other ideas that I
think constitute best practice if you have an animal in your care.
1. Number
one, they told me: Be nice. This was the priority I heard from the veterinary
staff with whom I spoke. Your veterinary
staff are doing everything they can, they really do care deeply about your
animal, they are experiencing unprecedented demand, and they are working hard
to provide the best care possible for everyone who needs them. You’ve probably heard
the saying “If you can be anything, be kind.” If you’re a country music fan, feel
free to substitute “always be humble and kind.” Either will work, and will be a
welcomed interaction with your veterinary professionals. It doesn’t cost
anything, it is sure to help, and there is no down side. In the world of
medicine, it doesn’t get any better than that. If you are always nice, you say,
then that’s terrific! Maybe do a little extra because I am hearing that there
are plenty of people who aren’t being so respectful and kind.
2. Adjust
expectations. It takes longer to get
an appointment or a question answered or a refill. It just does. That isn’t such
a big deal if we plan ahead. You know your dog needs a medication. Don’t wait
till the last minute for a refill. Anticipate there may be shortages in some
areas so prepare for that as well. Get extra food or other essentials if your
dog has specific needs. Be aware also that veterinary medicine is using remote
or telemedicine approaches just as human medicine is. Most state laws require
that veterinarians examine an animal in person in order to write prescriptions.
However, a telemedicine visit can be very helpful in narrowing down what is
going on and how urgent the situation is and how to handle it until you can see
your own vet. Our expectations need to adjust to incorporate some unique ways
of getting care just as we are doing with our own medical care.
3. Keep
a focus on prevention and being proactive. Some of the main reasons dogs need
ER visits stem from things that are easy to prevent. Your dog eats everything? Then
make sure there isn’t anything in reach
that is harmful. Take 60 seconds outside every morning to pull up those mushrooms
and scout the yard for other hazards. You can save yourself, and your dog, a
serious and expensive health problem. Consider play dates with dogs you know
and owners you trust rather than the dog park.
Choose appropriate toys and chews; the harder and more long lasting the
chew, the greater the potential for a broken tooth. That is one painful and
expensive outcome for you and your dog. Keep on schedule with regular exams at
the vet. By all means, keep up the heartworm preventives and get refills well
ahead of when you need them. Do everything you can for the health of your dog
(hopefully this isn’t a change for anyone). Be proactive so problems are
detected early and there is more time available to make an appointment. If your
dog has a history of ear infections, allergies, or hot spots, to name a few
common examples, check regularly so you catch a recurrence early. Talk with the
vet about what you can do to minimize recurrence or at the first signs of
trouble. Work with the vet to get to the cause of the problem so you may not
even have to worry about recurrence so much! This can take some trial and
error, but a dog with intractable ear infections or frequent bouts of diarrhea that
finally are resolved after a thorough test of different diets is well worth the
effort (every golden in my life would agree).
4. Along
with the above, it is helpful to learn all you can about your dog. Get your
info from good sources. The American
Veterinary Medical Association has a good page with resources for owners,
linked below. Look for professional organizations or veterinary schools,
veterinary offices, or the ASPCA as other useful sources. Learn what is normal
for your dog and what might be an early sign of trouble. A daily lump, bump,
ear, eye, teeth, and skin check takes less than two minutes depending on how
thorough you are and how often you pause to throw in a few loving glances and
“What a good boy!” praise. Not wanting to weaken my reputation as a “poop
expert,” I firmly believe that every dog owner should see, fairly close up, at
least one poop each day. That way you know that the dog pooped, whether there
was any difficulty pooping, and whether it looked normal for your dog or not. Checking
on urination is good, too. You might not see the output, but you will know the
dog was able to go without difficulty and how often. Looking at one poop a day
is a small sacrifice to make to avoid a much worse case of diarrhea and will buy
you some time until your vet can see your dog if a visit even becomes
necessary.
5. Know how to handle the unexpected. Keep an emergency kit for your dog including hydrogen peroxide if directed to use it for accidental ingestion (check with animal poison control before using it, though, as it could be harmful if used incorrectly). While we’re on the subject, did you know the American Red Cross offers Pet First Aid Courses? They actually are quite good and cover Heimlich maneuvers and CPR for animals, along with basic first aid. Your dog means the world to you and you would do anything at all to make sure it is well cared for? Well, there’s something you can do. The class currently is offered online and costs $25. If you feel helpless in case of injury, shock, bleeding, etc., completing such a class can be very empowering. Be aware that emergency facilities may only be able to see cases with true emergencies, the situations that threaten life, such as problems with breathing, bleeding, toxic exposure, foreign body ingestion, GI obstruction or bloat, heatstroke, and snakebite. Know where your local facilities are, know where there are urgent care options, call before going. If you know what to do in the interim, it just might save your dog’s life. Can’t stand the thought of having to do some emergency care for your dog? Well, there’s that prevention thing described above.
6. Plan for the expenses. This can help with your own stress around the care of your dog. It costs a lot to own a dog and provide it with proper food and medical care. Skipping routine care to save money may lead to bigger problems down the road, especially as the dog ages. I can’t think of a single situation in terms of human or animal health that is not improved by catching it early. One veterinary professional strongly suggested that people get insurance for their animals. There are numerous options available now and some workplaces even include a pet insurance option as a benefit, recognizing how important our animals are to our lives. Those of us who know and love golden retrievers realize the particular challenges that come with that breed and the various scenarios we may encounter with them as they age. We hope many of those won’t come true, but need to be prepared for the expenses nonetheless. The value of what we receive with stellar veterinary care and the advanced diagnostics and treatments available for our animals cannot be beat.
References
Alarming suicide rates reflective of stresses felt by veterinarians. https://www.wisfarmer.com/story/news/2021/05/26/alarming-suicide-rates-reflective-stresses-felt-veterinarians/7361193002/
Not One More Vet. http://nomv.org
American Red Cross, Cat and Dog First Aid training. https://www.redcross.org/take-a-class/first-aid/cat-dog-first-aid
American Veterinary Medical Association, resources for pet owners: https://www.avma.org/resources-tools/pet-owners
American Veterinary Medical Association. Veterinary telehealth: The basics. https://www.avma.org/resources-tools/practice-management/telehealth-telemedicine-veterinary-practice/veterinary-telehealth-basics
Telemedicine and how it works (VCA handout). https://vcahospitals.com/know-your-pet/telemedicine-and-how-it-works
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