Be concerned when the veterinarian exhibits an attitude of indifference, defensiveness, or denial toward past, dissatisfactory veterinary procedures which harmed the pet or ultimately took the pet's life. Dr. Allen warns against clients aiming to educate themselves (from a layperson's perspective) about animal healthcare issues, diseases, medical procedures, and other treatment modalities. The client seems to be expected to adopt a submissive, unquestioning attitude in deference to the doctor's awesome vault of infallible expertise. From Dr. Allen's perspective, it would seem that the "correct" mindset of the pet-owner is that of servitude, not one which empowers and collaborates with the doctor on medical decisions. Furthermore, Dr. Allen's view seems to imply that it is wrong for the pet-owner to express dissatisfaction with or concerns about previous veterinary treatments/diagnoses. It seems unacceptable to question the authority of any veterinarian, even if one fears a misdiagnosis or medical mistake.
Dr. Allen appears to suggest that some pet-owners are feeble-minded, and perhaps neurotic, as he makes the assertion that these clients seem unable to accept the realities of medical limitations and are unable to face reality, because they engage in magical-thinking, expecting miraculous cures to occur. This condescending attitude prohibits the right of the pet-owner to not only ask probing questions, but to question the judgment of the doctor at the risk of being labeled a "difficult patient." Episode 39 ("The Package") of the 8th season of the comedy "Seinfeld" is a perfectly humorous portrayal of what happens when a patient is branded "difficult." In this episode, Elaine discovers that a nurse previously wrote in her medical chart that she is a "difficult patient." That label was applied to Elaine when she refused to don the paper examination gown for a procedure to remove a mole on her shoulder. Elaine had worn a tank-top in order to avoid disrobing, logically assuming this would not be a hindrance to the doctor removing the easily-accessed shoulder mole. When Elaine learns she has been defined as "difficult", she pleads for the doctor to erase the word from her chart. The doctor dismisses her concern, and the medical community is alerted that Elaine is "difficult". Thereafter, Elaine has trouble making appointments with local doctors because of this label and because no doctor wants to deal with a "difficult patient."
Be concerned when details are obscured behind a veil of medical superiority; be warned that you, the client, are not on a "need-to-know basis." This approach is reminiscent of an era in medicine when doctors thought it best to withhold medical information (particularly terminal conditions) from the patient and often from the patient's own family. They believed the truth would hamper the patient's recovery (if there was to be one) or expedite the dying process, because the stress of the truth was too burdensome. Another example of this form of medical deception from television was filmed in an episode of "Mad Men" (Season 4, Episode 3) when Anna's bone cancer is kept secret from her by her family. Historically, the doctor-patient relationship has been one of a paternalistic attitude toward patients; the doctor would make decisions for the patient's treatment as a benevolent, wise father would make decisions for his immature, naà ¯ve child. Therefore, doctors' authority and competence were rarely questioned by patients or family members. But, times have changed from these Victorian attitudes, as patients increasingly desire to become empowered in their medical decisions and to collaborate with doctors, rather than yield unquestioningly to an authoritarian figure.
Be concerned when the veterinarian denies or discounts the probability of incompetent or unethical actions or medical negligence. My personal experience of having a pet die under circumstances which seem indicative of serious medical malpractice opened my eyes to the fallibility of veterinary practitioners. Admittedly, I formerly esteemed the quality of veterinary care to be superior to even that of doctors treating human patients. I wrongly assumed because vets treat animals who don't speak an audible, universally understood language that they had to be twice as good and work twice as hard as their colleagues who treated humans. I was proven wrong by the dreadful circumstances which took my own pet's life. During and after that tragedy, I quickly noticed that nearly all of the several vets who treated our pet (after the initial event of negligence which caused a cascade of medical crises until the pet died 3 weeks later) seemed eager to dismiss the notion of possible medical malpractice whenever I brought up the subject. I was careful early on not to pass quick judgment or to blame until I had gathered the evidence I needed to understand the cause of my pet's death. Suffice it to say I noticed what I call the "good ol' boy network" of vets seemingly collaborating to protect their colleagues' reputations and practices. The collaboration to cover up medical malpractice appeared at the local and state levels, and I fear it is a nationwide conspiracy. No one wanted to take responsibility. I was told emphatically by one vet, "But it was no one's fault!" No one wanted to admit the truth of my pet's tragic death, even after I paid for a necropsy conducted by a leading veterinary medical school. I thought the necropsy would yield definitive answers. It was murky, at best: the pathologist's inconclusive findings were disappointingly impossible to help me gain vindication for my pet's death. Veterinarians, like other healthcare professionals, are fallible human beings and we should never forget their ability to make medical mistakes.
Beware of inflated egos, arrogant attitudes, and narcissistic traits in veterinarians. I am reminded of a popular adage: "There is a God, but you're not he/she/it!" I think some vets would add to that, "But I am!" Most of us have heard stories of some doctors who have a godlike superiority complex. Such doctors will treat the pet-owner condescendingly, as they expect nothing short of blind obedience to their medical expertise. There is no sane way to interact with such unbalanced persons. Advanced education, prestigious achievement, lengthy credentials, and approval/recognition from colleagues, institutions and organizations do not necessarily guarantee the quality of personal and professional behavior, ethics, and expertise in any one veterinarian. Interestingly, I have recently read some online articles about "bully doctors", a phenomenon of which I was previously unaware. Such doctors engage in psychological bullying of nurses and even patients. Some nurses are now coming forward to describe such incidences that happened to them on the job. Apparently, these doctors bully because they either perceive or believe that their advanced education and training entitles them to feel superior and to berate nurses, other healthcare workers and even patients.
Beware the vet or doctor who relates long-winded personal stories to you during your appointment. In Dr. Allen's guidelines to avoid "troublesome" clients, he icily describes "needy" clients inappropriately emotionally expressing themselves to him during his own veterinary practice. He warns against the danger of clients developing favoritism for a particular vet in a practice with multiple vets. He claims this is ill-advised for all parties involved, and in this one point, I must agree with Dr. Allen (although I generally disagree with the rest of his article.) I do think misguided loyalty is a dangerous thing. However, has Dr. Allen never considered the possibility of the veterinarian being guilty of divulging too many of his/her personal details? I have personally received irrelevant and unwanted personal information 3 times from 3 different doctors (1 vet and 2 doctors who treated human patients.) Wanna talk about annoying, inappropriate, "needy" behavior? The worst experience happened recently when I accompanied my husband to his appointment to see his oncologist. My husband was diagnosed with Hodgkin's Lymphoma. I like to attend my husband's oncology appointments so I can hear information on my husband's status from the doctor himself. And I like to ask questions, plenty of questions. My purpose is to gain all the knowledge I can to assist my husband in his cancer fight. During the last appointment, I asked the oncologist his opinion of alternative/complementary therapies as an adjunct to traditional treatments. Specifically, I asked about adding in the practice of meditation to accelerate healing. I wanted more information (from the oncologist's perspective) on the mind-body connection in relation to overcoming cancer. The doctor then launched into a brief discourse about his own religious beliefs. His thoughts were interesting, but irrelevant. I learned nothing from this highly educated oncologist about using meditation to fight cancer, but I learned all about his spirituality instead. That is not what I wanted!
In summary, I wish to add that I am not antagonistic toward vets or the medical profession as a general rule. Fortunately, most of the vets I have used over the years have treated me respectfully and displayed compassion and skill in handling my pets' medical needs. But, it only took one tragedy to change my attitude from complete trust to constant caution, teetering on the edge of chronic suspicion of the entire veterinary profession. Lastly, I am fortunate to have a close friend who is a medical doctor who has taught me many wise lessons, including "following my gut" when seeking out medical advice or treatment and seeking out other opinions if necessary. I don't believe in exhausting the gamut of vets or doctors until I find the one who tells me what I want to hear. I am only looking for respect, honesty, compassion and integrity. Persistence in searching for a vet for our pets or my own personal doctor is now my overall guideline to avoid entrusting the wrong person with our health.
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