qualities of good clinician

[gracietiger]

I am wondering what you guys think are key qualities of a good clinician. Not necessarily a good overall vet, but more specifically a good doctor - diagnostician, surgeon, etc.

For example, does one need to be better at thinking outside the box when problem solving, or is it okay to be a more black and white thinker? Should one be really good at visual perception, or can a weakness in visual perception be overcome with a lot of knowledge? Can anxiety-prone people be just as good doctors as their cool as a cucumber peers? Does one need to be able to think very quickly on ones feet, or can a person be a good clinician by absorbing, thinking and concluding before reacting? Are good clinicians those who are emotionally invested in their work, or do they remain more detached?

These are just examples and I know that there are no answers to these questions, but I am interested in hearing opinions from those who have spent more time in the clinic about what kinds of qualities make a doctor a really good doctor. I am a non-trad who became tired of my career and decided to suddenly make a switch to pursuing vet med. I do have several hundred shadowing hours, but not much hands-on experience. I have spent the last two years busting my butt to do what it takes academically to gain acceptance into school, and I think that the focus on just getting in has overshadowed the need for a personal assessment as to whether or not I am a good fit for this profession.

I have very strong academic abilities but I don't think that necessarily makes for a good doctor. I have some attributes that I worry would not be well suited for a career in medicine. As much as I want to be a vet, at the end of the day all that matters is that the animals are in good hands. Plus, I would hate to wind up in a profession that I ended up not being very good at.

So I would really love to hear some insights about what makes you believe you'll be a great clinician and/or what makes the doctors you have worked with really good doctors.

And, just for fun, I'm also curious if people had encouraged you to become a doctor/vet before you began this path because they could "see" it in your personality. When you were younger, or before you selected a career path to pursue (which comes later for some of us!), what did people tell you that you should do because you'd be really good at it? Everyone tells me I should be a politician or lawyer - which I take very offensively - and no one has ever suggested I become a doctor. Go figure...

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[PetPony]

I can't really say anything about the qualities because I haven't worked much with vets yet, but people have always told me that I should be a doctor. Next year, I can finally start with my pre-vet stuffs and I am very excited. In the summer, I'll be shadowing vets and I'm gonna have an internship in Germany.

The weird thing is that even though everyone's told me that I should be a vet, when they hear how much work it involves to just get into vet school/become one and how much it will cost, most of them change their mind and say it's a waste of time and money that someone else should spend, although I am usually pretty good at school. They think it's too much effort to get to the end result of being a vet. They tell me I could do it, but shouldn't..

 

[nyanko]

You will find all of those types of people in veterinary medicine, and they will all be good veterinarians in different ways.

I'd say the most important thing is to KNOW what your strengths and weaknesses are intrinsically, play to your strengths, try to improve your weaknesses and know your limits and when you should ask for help.

IMO a good clinician is someone who uses what works for them in the best manner possible to provide the best care that they can. And another thing - I was talking about this with my faculty mentor the other day. People tend to gravitate towards what they are good at, in the long run. The thing about vet med is that there are so many options - if you decided during school or after that you didn't feel cut out for being a clinician, you're still likely to find some path that suits you better within the field. I'd venture to guess that a day in the life of a general practitioner in a Midwestern suburb vs. a veterinary pathologist with the CDC require and highlight quite different skillsets. Honestly, an affinity for science and medicine, a healthy curiosity and a desire to use whatever skills and strengths you do have to advance animal and/or human health and welfare are really the most important things to have IMO.

 

[SocialStigma]

I agree with nyanko, people can be good vets in different ways. But I definitely think all clinicians should be able to think outside the box and have a passion for what they do.

I was 8 when I decided that I wanted to be a vet so nobody had told me I would make a good vet/doctor before that since my interests were very varied at that age and it was not yet obvious from school grades that I am strong in sciences and maths. But throughout high school and even now in university, I get people assuming that I'm going to be a doctor all the time (likely because I'm in a pre-med program). Sometimes I don't bother correcting them because I have to go through the "why would you become a vet when you have the potential to be a doctor" talk.

 

[168135]

You also have to be a fairly compassionate person.

I worked with a small animal vet who is more of a large animal person than a small animal person. Half of the time, he doesn't really acknowledge if an animal is acting scared or aggressive unless it happens to be jumping around all over the place. He just kind of walks into the room, looks at his chart, "Oh, Spot needs this dead toe nail removed." He seems to look past the animal completely, focuses on the toe, yanks it out and walks away. He just seems a little detatched from everything... a little cold... I volunteered there for well over a year, and made sure that when my cat came in, she saw him. He tended to forget that I owned a cat. It was just odd. The atmosphere in the clinic was neutral or tense some of the time.

The current clinic I volunteer at is pretty awesome. Even though the clinic is just as busy, all of the staff connects names to patients to conditions to temperment and greets every animal that comes in for a procedure. If an animal is howling in pain over something the doctor or tech did, they'd take a few seconds to try to calm the animal down before they continue. If an animal is a nightmare to work with, they laugh about it afterwards and shrug it off.

One day, I told the tech that my honours supervisor was a client. When I told them it was Dr. X and his wife, her face lit up and she says "Oh... the cats from *this state*!!! That's the first time I've ever seen cats from *this state*!" and she told the vet that I knew the clients well.

It creates a very positive atmosphere. The staff takes a lot of interest in their clients, and the clients just love them for it. I've talked to some people in passing who are clients of this clinic. I had a cab driver one who just adored the vet. "Usually vets don't pay much attention to what I have to say about my animal, but this vet actually listens to ME and my concerns. She's a sweetheart." The vet has done other things to give back to the community. She opened the city's first dog park, is offering free spay/neuter for clients with ferals and strays, and she invited the community to an open house at the clinic. She had presentations on surgical techniques, common diseases, a "Guess the animal in the x-ray" contest.

I think if a vet had a fraction of this vet's enthusiam and compassion, then they'd make a great vet. She's become one of my rolemodels over the last couple of years.

 

[DVMDream]

One of the most important things I have seen for a veterinarian to have is patience. Patience with clients, patience with animals, and patience with the rest of the staff. There will always be that difficult client that just doesn't understand what you are explaining and you will have to repeat yourself 5,000 times before they get it but you can't get frustrated or give up. There will be the flying, hissing, spitting, furball of a cat that will test the best of your patience but you can't show your frustration and anger because it will put the cat more on edge. There will be the dog that wants to eat your face off, alligator rolls, urinates, defecates and anal glands all over the place just for a nail trim but you have to continue on. Patience is key. Not every client will understand on the first explanation, not every patient will sit or lay down without moving, growling or biting while you poke and prod them and severely ill pets will not get better overnight. It takes patience to deal with clients, pets and to see a pet through a condition until they are back to being completely healthy (if completely healthy is a possibility). Patience is a very good trait for a veterinarian to have.

 

[gracietiger]

You guys are so well-spoken and I really enjoyed reading your thoughts. Perhaps I may get a little more specific about some of my weaknesses and why I have some self-doubt.

For starters, I am prone to anxiety. Well, 98% of the time I am go-with-the-flow, but when I'm under pressure, I am not just prone to anxiety, but panic attacks. They are very very rare, and not something I even considered being an issue in my future career. However, I had a bit of a wake up call the other day while I was shadowing a vet and she accidentally cut off a bit more tissue than intended, which left it very difficult for her to close the incision. She spent quite some time trying and trying, and I could tell she was growing concerned and frustrated. Ultimately, she totally kept her cool (she's amazing) and everything worked out.

I watched this, and believed that this is a situation that doesn't agree with me - not just mentally, but physiologically. Everyone in my family has anxiety so no matter how level headed I may think I am in a situation, my adrenals cannot be reckoned with. In this situation, I am worried that between the pressure of time, and being concerned I wouldn't be able to complete a task, I'd be out the door.

I am also very very hard on myself. Which means I just dump more anxiety on top of anxiety, but I am very concerned that I wouldn't be able to handle mistakes very well. I mean, I make mistakes all the time (and mull over them for a long time), but as a veterinarian, if I harmed an animal, I am not really sure how I would react. Perhaps I'd be able to be fine, perhaps I'd lose it.

Does anyone have these same concerns? Are these things that pass with time and patience? Or are they things that are major red flags for someone potentially operating/caring for living creatures?

 

[bunnity]

Well, you would not be alone in that personality type. I'd say it describes about 50% of my class at least.

I do have to warn you that at least at Penn there are a lot of initially very healthy sane people ending up with panic attacks and anxiety and being in a really bad mental state of mind. I had to take last year off because I was not sure if I could handle the environment (doing fine now though). I have had several friends having anxiety attacks, going on meds, or a couple just straight up failing out. While I hope it is better at other schools, it is very difficult mentally here at least.

I will add that there is no drama or competitiveness; the pressure is all due to the workload and schedule.

 

[that redhead]

Are you seeing a therapist, taking medication or finding some outside source of assistance for your anxiety? The posts you've made make me think that you're not entirely sure you want to pursue veterinary medicine, and while that is 100% OK, it's something I think you need to mull over a bit more yourself or even with an outside listener (kind of like us, I suspect, but with the professional ability to include your anxiety in the full picture).

I'm not sure if its "just" your anxiety leading you to question veterinary medicine, and if so, maybe all you need to do is get a bit of help with it to overcome that self-doubt. But so many of your posts seem to bring up a different issue with why you (subconsciously?) feel you are a mismatch for the profession and I don't think it should be taken lightly. While Nyanko is right that there are all kinds of veterinarians who are able to be successful despite different weaknesses, I personally believe the ability to function well under pressure and handle stress are huge traits that all veterinarians should possess in some shape or form. Not to say that this is the only valuable ability in the profession, but my opinion on one of the primary ones.

 

[catvet85]

You guys are so well-spoken and I really enjoyed reading your thoughts. Perhaps I may get a little more specific about some of my weaknesses and why I have some self-doubt.

For starters, I am prone to anxiety. Well, 98% of the time I am go-with-the-flow, but when I'm under pressure, I am not just prone to anxiety, but panic attacks. They are very very rare, and not something I even considered being an issue in my future career. However, I had a bit of a wake up call the other day while I was shadowing a vet and she accidentally cut off a bit more tissue than intended, which left it very difficult for her to close the incision. She spent quite some time trying and trying, and I could tell she was growing concerned and frustrated. Ultimately, she totally kept her cool (she's amazing) and everything worked out.

I watched this, and believed that this is a situation that doesn't agree with me - not just mentally, but physiologically. Everyone in my family has anxiety so no matter how level headed I may think I am in a situation, my adrenals cannot be reckoned with. In this situation, I am worried that between the pressure of time, and being concerned I wouldn't be able to complete a task, I'd be out the door.

I am also very very hard on myself. Which means I just dump more anxiety on top of anxiety, but I am very concerned that I wouldn't be able to handle mistakes very well. I mean, I make mistakes all the time (and mull over them for a long time), but as a veterinarian, if I harmed an animal, I am not really sure how I would react. Perhaps I'd be able to be fine, perhaps I'd lose it.

Does anyone have these same concerns? Are these things that pass with time and patience? Or are they things that are major red flags for someone potentially operating/caring for living creatures?

i would suggest searching for an alternative solution to medications etc. it might sound crazy to put this in a medical forum, where we are usually told that pure science is the only way, but try a naturopathic doctor. it will cost you a bit but they can really help (make sure they are legit and went to an accredited naturopathic school). they tend to look past the symptoms and help w/ everything. follow exactly what they say and you should get a good handle on stress. someone very close to me just went through an essentially mental break down that included panic attacks etc (because of vetschool i might add), and this brought her back to her almost normal self. takes time but you can do it and there are ways!

 

[WhtsThFrequency]

For example, does one need to be better at thinking outside the box when problem solving, or is it okay to be a more black and white thinker? Should one be really good at visual perception, or can a weakness in visual perception be overcome with a lot of knowledge? Can anxiety-prone people be just as good doctors as their cool as a cucumber peers? Does one need to be able to think very quickly on ones feet, or can a person be a good clinician by absorbing, thinking and concluding before reacting? Are good clinicians those who are emotionally invested in their work, or do they remain more detached?

Interesting questions.

To be honest, I think a lot of it depend on specialty (or, if you don't specialize, your general type of work).

For example, a general small animal practice vet would do better if they were very sympathetic people who became very involved in their cases.

In my case (anatomic pathology) I do need to retain a pretty good sense of detachment from cases, or else I can't do my job, considering how much death I see (necropsy) and cancer, infection, etc (biopsy). (( FYI I also suffered panic attacks for years....ironically, as soon as I got out of school and into residency, they stopped....if you are lucky enough to find something that you like to do all day every day, your anxiety will even itself out.))


An emergency vet needs to be able to think of their feet. A radiologist needs to be able to take the time to carefully evaluate things. Likewise, a radiologist needs more visual perception than an emergency vet.

A large-scale food animal practitioner must have a very good sense of economics and must remain detached from the herd - the minute you start making emotional choices, you risk doing your client a disservice. A small animal practitioner, should (or at least can) be a more emotional type since you are dealing with "family members" essentially.

 

[milkmaid]

There's some really great lengthy answers here - definitely enjoyed reading them - but my all time favorite quote is much shorter.

"The three C's of a good vet: Competence, Confidence, and Communication."

 

[alliecat44]

I completely agree with all that's been said, and would like to emphasize that a) your panic attack issues can be addressed and might NOT be a problem in veterinary medicine depending on which career path you choose (examples: pathology, research, behavior, industry, public health, etc).

One quality that I would add as essential no matter what type of practice (or non-practice! ) a veterinarian pursues is that of curiosity. Good veterinarians never lose their curiosity or desire to keep learning. You will literally see something you have never seen before every single day that you are out there. That feeling of amazement and curiosity to learn more is essential in looking for the answer to that problem and providing the best care for your patient. The second you lose your curiosity or compassion is the second you should leave the profession, IMHO.

Also, curiosity is essential to make sure that you don't practice 2011 medicine in 2025.