Thursday, February 16, 2017

A Mile Wide

When people say that it must be harder to be a veterinarian than an MD they often make two observations. The first is that our patients don't talk. (As an aside, this is actually not always a bad thing. It's difficult enough to sort through contradictory information between the husband and the wife without the cat talking too...) The second observation is that we have to deal with so many different species. This is correct for the profession as a whole but in truth there aren't very many James Herriot "All Creatures Great And Small"* types around any more. More and more of us restrict our practices to a handful of species. Which is of course still more than one.

However, what people often don't consider, and what is truly difficult (but fun), is the range of what we can do. Physicians are usually limited to family practice or a specific specialty, whereas as a veterinarian in general practice I am a "family doctor", an internist, a general surgeon, a dentist, an anesthesiologist, a radiologist, a behaviorist, a nutritionist, an oncologist, a cardiologist, an ophthalmologist, a dermatologist, a pharmacist, an obstetrician, a pediatrician, a gerontologist and a bereavement counselor.

I am a mile wide.

And, as the aphorism goes, unfortunately sometimes (often?) just an inch deep. To be fair, the depth does vary. Most of us are deepest in the general medicine / family doctor, internal medicine and general surgery categories and then have a handful of other areas of interest where our depth exceeds the proverbial inch. Three things save us from malpractice in the shallow zones.:

1) Colleagues. Veterinarians, as a rule, get along well together and veterinarians, as a rule, know their own limits. Strengths and weaknesses tend to balance each other out within a group of veterinarians working together so cases are discussed and shared. And when this is not enough, or for those in solo practice, referral to specialists or to colleagues in other practices with particular training, experience or equipment, is common.

2) Continuing Education. In order to maintain our license we have to attend conferences where new information is presented and where refresher courses are offered. I was just at a conference in Florida last week for exactly that reason. Sure Philipp, a "conference" in Florida... in February... how convenient... Ok, we did tack on a holiday after, but honestly, during the conference time the warmth and sunshine outside were an abstraction when considered from the artificially lit, aggressively air conditioned interior of massive lecture halls. But it was fun! For those of you youngsters out there, here's a fact that may surprise you - learning is big fun when there are no exams or assignments or pressures of any sort.

3) The Internet. There, I said it in a public forum. Vets look stuff up on the internet. However, I don't mean the wide open internet, but specifically the Veterinary Information Network, or as we all call it, "vin". Vin is a life saver - literally for some of my patients - and it is something other professions are jealous of. It's an online subscription service that allows us access to scores of specialists to whom we can post questions on open forums**. It also has an impressive array of tools and resource materials and, as it has been running for about 15 years, it now has such a massive searchable database of past questions that I am often hard pressed to think of anything new to ask. Here's a secret: when your pet has something odd and your veterinarian pops out of the room for any reason or excuse, chances are they are also quickly logging into vin...

Being wide keeps things interesting. Being shallow keeps things scary. As with most things in life the key is in getting the balance right. And in leaving the hippos to the specialists.

*Widely referred to among veterinarians as "All Creatures Grunt And Smell".

**The free public access sister site is , which is a reliable and highly recommended source of information when you are tempted to check in with Dr. Google.