Not-So-Good Vets

[Groominator]

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I have yet to see any talk about "bad" vets on here. I'm in a gossip mood. I don't necessarily mean bad doctors (although those exist too). More like ones that abuse their position, and their clients' naiveness. Some vets are businessmen first, doctors second. Often its an ethics sort of thing.

BTW I know there's always two sides to an issue, there's ungrateful clients and burnt out doctors. I'm interested in a civil discussion and maybe some stories.

The first vet i volunteered for when i was very early in high school was the businessman type. He really did put money first. He was the sort of doc who prescribed every single client with science diet and sold them enzymes (that he marketed as a vitamin) regardless of what the case was. The cages were never empty. He was the sort of doc who would admit to the staff that an animal was about to die but would pump them full of treatment anyway, to charge the clients. He wasn't really a bad doctor, most of his patients did improve, he just always did a lot of unnecessary procedures, and not for diagnostics purposes. He really seemed like a burnt out doc. Once he made me and another volunteer call clients who had not been to his office in four years to offer them appointments. Mortifying. He'd advertise for grooming and treating exotics even though his clinic did not offer either of those. He was a bit of a jerk to the staff too, but I'm not even talking about that. Heh, I once was exploring the basement of the clinic and found a huuuuge stack of folders labeled "Clients suing Dr. ___". With his empathy skills to both clients and animals, i can't say i blame them.

Of course a lot of this stuff i didn't put together in my mind until after I stopped working for him. I also heard some horror stories from the techs, although i wasn't there to see it so i can't vouch for any of that . But I did not exactly find the way he practiced medicine to be encouraging at all. In fact my "faith" was not restored until the next doc i volunteered for, who was quite the opposite. A minimalist with great intuition, and who always tried to be considerate of his clients (and their wallets). I would still be working for him, except he unfortunately relocated to a different clinic rather far away.

 

[No Imagination]

Once he made me and another volunteer call clients who had not been to his office in four years to offer them appointments. Mortifying.

I see nothing wrong with that. In fact, I wouldnt have waited 4 years. Most vets i've worked for did it every year (or a postcard).

What I HATE are the practices of, Veterinary Animal Company (VCA) - I have no idea why the acrnym is the way it is.

I tech'ed for them for a few years. Was run like a corporation, and what I disliked the most, were the financial incentaves they gave to US (the tech's) for convincing the clients to do certain procedures (We would get bonuses if we were able to convince clients (who in the past declined) heartworm or GI parasite testing. - Not the job of a tech and financial rewards are not the way to go.

Finally, they refused to treat my dog, who had heartworms, because I declined treatment (age was major factor, as well as the arsenic based treatment they still used). I instead opted for the "Preventative method', of killing off the micro filaria and let the adults die to old age. (Don't know if that is still employed, but my dog lived to 15 (Shepard))

 

[InfiniVet]

Finally, they refused to treat my dog, who had heartworms, because I declined treatment (age was major factor, as well as the arsenic based treatment they still used). I instead opted for the "Preventative method', of killing off the micro filaria and let the adults die to old age. (Don't know if that is still employed, but my dog lived to 15 (Shepard))

Well honestly it's because they'd be liable because you can kill your dog that way. Thats really good that your dog lived to 15 🙂

 

[Groominator]

I see nothing wrong with that. In fact, I wouldnt have waited 4 years. Most vets i've worked for did it every year (or a postcard).

In fact he did postcards. But one day he decided he wanted more appointments and the way to do it was by printing out a full list of his clients and calling each and every one of them personally. Awful idea and a lot of them told me off for calling them, especially those who had vaccs 6 months ago and were being invited to get vaccs again, and those who were now loyal to other clinics. I was 14 so i was very... submissive and hated phones so it was the worst experience ever.

As for corporation type clinics, I've heard awful things about Banfield. But I know nothing about them, I don't even know if they exist on the east coast. And this was from clients, not from anyone working there. Particularly the complaint was about them being very impersonal and having package deals that don't suit imdividual needs. But again, i have never seen a Banfield clinic in person.

 

[No Imagination]

Well, your the vet student, and im not. But go and take a look at the success rate of the old'er arsenic treatment. It's killed lots of animals.

Im aware of the chances of a pulmonary edema (correct terminology?) of not treating, but killing the adults worms can have the same result.

Putting an animal on the preventative has the same result, just takes longer, and with no filaria there should be little or no chance of reinfection.

I'd do it again vs. treating with the arsenic (ever see what happens when a vein blows while giving that stuff? Its nasty)

 

[Groominator]

I know a woman (well, online) whose dog developed heartworm at 10 years old and she treated with an entirely holistic approach. The dog survived the worms and lived to the age of 17. Her "program" - http://www.banditsbuddies.com/treatment.shtml

just in case anyone finds it interesting.

 

[david594]

Anyone familiar with treating for the wolbachia before treating for the actual heart worms?

Supposed to reduce the risk of shock and embolism from the dieing worms when the adulticide is used.

 

[twelvetigers]

I heard about that David! My vet was trying to discuss it, and she couldn't remember the word for the parasite - I got to show off by remembering it. 🙂

Who would think of a secondary bacterial infection in treating heartworms? Or, I guess I'm just assuming that's what would be happening. Anyone know a good paper on the research?

 

[nyanko]

The journal Veterinary Parasitology actually has a Heartworm Revisited issue coming out (Volume 158, issue 3, pages 163-268, December 10, 2008, e-published ahead of print if your institution has access to the journal online). There are a few little studies in there about Wolbachia treatment in conjunction with ivermectin and melarsomine. Interesting reads.

 

[168135]

I've seen the vets at my old clinic do some pretty questionable thing. One vet, who does large and small animal, decided to have a half-hour long conversation about HORSES while a dog was on the table, asleep, waiting to be spayed.

Also, a vet from that clinic talked me out of getting bloodwork done on my senior cat, who hasn't had bloodwork done in over four years. Isn't it recommended that you get annual bloodwork when your cat turns senior 😛

Also, I've seen a lot of sketchy things go on in surgery (not changing gloves between surgeries, never wearing masks, sometimes not wearing hats, techs doing cat neuters, cross contamination of instruments)... cutting corners to the extreme.

After seeing how a GREAT vet runs a clinic... I don't want my cat going back to my old clinic ever again... but since it's my mom who pays for her checkups, I don't have a say. It took me two years to talk her into taking Susie for a checkup, and a year and a half to persuade her to get bloodwork done. *headdesk*

 

[rachroo]

I think what's really important concerning this issue is that we as "pre-vet" students or as actual vet students, learn from others in the field. We can learn a lot from others (not necessarily just veterinarians), even if we don't agree with them!

I know that no matter where I've worked or volunteered, I always find some things that I say, "Well, that's something that I would want to do/treat/act differently" or "Wow, that's a good idea/attribute/way of thinking about things, I'd like to be like that."

 

[alliecat44]

I heard about that David! My vet was trying to discuss it, and she couldn't remember the word for the parasite - I got to show off by remembering it. 🙂

Who would think of a secondary bacterial infection in treating heartworms? Or, I guess I'm just assuming that's what would be happening. Anyone know a good paper on the research?

It's actually not a secondary infection; rather, the Wolbachia bacteria actually parasitize the microfilaria/heartworms themselves. A heartworm that is itself infected with Wolbachia is capable of causing increased morbidity (i.e. severity of illness) to the host (dog/cat). Also, Wolbachia-infected heartworms are more resistant to Immiticide (the only drug approved to treat heartworm infestations in dogs).

Therefore, killing off the Wolbachia theoretically makes the heartworm infestation less pathogenic to the dog and increases the success of the treatment (so the thinking goes and so preliminary studies have shown).

Pretty cool. Current thinking with a heartworm-positive dog is to treat with doxycycline for a month or so before immiticide--allowing the immatures to mature to the adults (Immiticide is only effective against adults) while ridding the heartworms of the bacteria and making them more susceptible to the Immiticide. Of course, prednisone can be used for symptomatic treatment in the meantime while you wait for Immiticide treatment--if indicated.

My understanding as a vet student, anyway. Neat stuff!

 

[CookieBear]

I see nothing wrong with that. In fact, I wouldnt have waited 4 years. Most vets i've worked for did it every year (or a postcard).

What I HATE are the practices of, Veterinary Animal Company (VCA) - I have no idea why the acrnym is the way it is.

I tech'ed for them for a few years. Was run like a corporation, and what I disliked the most, were the financial incentaves they gave to US (the tech's) for convincing the clients to do certain procedures (We would get bonuses if we were able to convince clients (who in the past declined) heartworm or GI parasite testing. - Not the job of a tech and financial rewards are not the way to go.

Finally, they refused to treat my dog, who had heartworms, because I declined treatment (age was major factor, as well as the arsenic based treatment they still used). I instead opted for the "Preventative method', of killing off the micro filaria and let the adults die to old age. (Don't know if that is still employed, but my dog lived to 15 (Shepard))

VCA is Veterinary Centers of America. If it's run like a corporation, that's because it is. But, just like with everything else, you will have the good and the bad. Not to make the analogy, but I shall - just like Banfield may have good and bad individual clinics, you have different vets and different staff at every VCA. No two are going to be identical, even if the ideal is to have the same high quality and excellence at each. I don't want to start a rant thread, or a love fest, but I was employed by them for a very long time, and I would work for them again, but, I do understand the good and the bad. You will find both in corporate, as well as in private, practices. And, I did also work in private practice... so it's not like I can't see the other side too.

IMHO, I think there's nothing wrong with a veterinary practice operating at a profit. A hospital that is not profitable is not going to be able to offer the best to its staff nor its clients. I also don't think there's anything wrong with rewarding educated, well-communicating staff members if they do happen to persuade a client who has never heartworm-tested or run a fecal in the past. If it's good medicine that you're 'selling', I don't see why the staff can't share in the profit. Whether it's profits based on fecals, or flea products, why shouldn't staff share in that?

Maybe it's a dirty fact to put out there, but there are many practices that pay a veterinarian a base salary plus 'commission' based on production. The veterinary field is certainly not the first to do that, and it's found in both corporate and private practice.

 

[cerealrhapsody]

Yeah, there are definitely some bad vets out there. My family has had some bad experiences on the client end, and the vet I volunteered with this past summer was a HUGE jerk. He seemed to be a pretty good doctor (and very fair business practices), but he was really unprofessional. i.e. cursing out myself and other people on the staff in front of clients, calling me names when i would make mistakes, etc. etc. 😕

but like someone else mentioned, it's ultimately good to experience some of that because it really makes you think about how you would want to run your business both as a vet and as a manager/employer.

 

[TrocarKarin]

When I got one of my dogs from the shelter, the shelter wouldn't let me take him home until he was neutered, and wouldn't drop him off at my regular vet's office, since they were too far away. So I picked a well-known clinic that's close to the shelter for the neuter.

Apparently the vet that neutered my dog didn't tie off the arteries correctly, the sutures came undone, and my dog started to hemorrhage. The emergency vet clinic told me flat out that the vet that doctor who did the neuter screwed up, didn't tie his sutures correctly, and almost killed my dog. They also reassured me that the vet who screwed up should be responsible for paying me back for the emergency charges, and they would back me up if necessary.

When I returned to the original clinic the next morning to let them know how badly they had botched the surgery, they tried to blame it on the suture company, they tried to blame it on me for letting my dog jump after surgery (he was passed out all day, and was not jumping,) and did everything in their power to avoid responsibility. The front office at the clinic knew that the Dr. was in the wrong, and kept apologizing for him, but the doctor wouldn't pay for the emergency surgery and blood transfusion until, in his words "he got reimbursed from the suture company."

It took me a couple months of hearing this story until I had enough. I was filling out the paperwork to take the vet to small claims court, when I had the brilliant idea to call the Tom Martino Troubleshooter radio show, and ask him for help. Within half an hour of talking to Tom Martino, I'd gotten a call back from the vet saying my check was at the clinic, and berating me for "trash talking him on public radio", even though the segment didn't air.

The lesson I took from all of this? If the doctor who couldn't tie a suture correctly had said something along the lines of "I'm human, humans aren't perfect, and we make mistakes sometimes. Medicine is part science and part art, and its not perfect. I'm sorry about your dog, it was my fault, let me reimburse you." I would have been a lot happier. I might still use the clinic. Instead, he chose to place blame on everybody but himself, almost got taken to court, easily could have gotten bad press, and I was angry enough to seriously consider reporting him to the state board. I told my dog trainer this story, and when new clients ask him for recommendations, he tells them to avoid this place like the plague.

I decided that when I'm a vet that I will always take responsibility for any mistakes (because everybody makes them, and I know I'm not special,) I'm going to be honest with clients, and I'm going to make sure I do the right thing for the animal and its owners. Not only because its the right thing to do, but because I think its better for the practice in the long run, and avoids much negative publicity.

 

[Malhi]

The shelter that I volunteer at, has one vet who tells the techs when to turn off the gas while she is operating. The techs hate it because she doesn't know what she is talking about. Unfortunately, we have had animals start to wake up while they're still being stitched up! She never learns though. 😡

 

[tealamutt]

Since I notice most of the posters to this thread are pre-vets I wanted to pass along a story related to this topic. A good friend of mine in my vet school class was asked about a 'bad vet' when she was interviewing. They wanted to know how she handled adversity and didn't mention anyone in particular. Well she gave them an example of someone awful without naming names. Unfortunately they had her work history in front of them and the wife of one of her former employers was on the board. 2+2= wait a minute!! The guy has a horrible reputation 3 states wide so they knew right away who she was referring to. She didn't get in that year, despite a great application (not saying it was because of this... but not saying it wasn't). I'd just be very careful about saying anything like that in an interview. Also, since we'll all be on the receiving end of negative comments made by collegues someday, it's best to be careful what you say in a professional context as well.

just my $0.02 we talk a lot about this in one of our classes, so it's kind of on my mind...

 

[LucyLoo]

Since I notice most of the posters to this thread are pre-vets I wanted to pass along a story related to this topic. A good friend of mine in my vet school class was asked about a 'bad vet' when she was interviewing. They wanted to know how she handled adversity and didn't mention anyone in particular. Well she gave them an example of someone awful without naming names. Unfortunately they had her work history in front of them and the wife of one of her former employers was on the board. 2+2= wait a minute!! The guy has a horrible reputation 3 states wide so they knew right away who she was referring to. She didn't get in that year, despite a great application (not saying it was because of this... but not saying it wasn't). I'd just be very careful about saying anything like that in an interview. Also, since we'll all be on the receiving end of negative comments made by collegues someday, it's best to be careful what you say in a professional context as well.

just my $0.02 we talk a lot about this in one of our classes, so it's kind of on my mind...

Ouch!!