RANT HERE thread

Veterinary Science Graduate Programs from U. of I.
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Minnerbelle said:
This... it was dripping with sarcasm.
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cdoconn said:
I realized AFTER I wrote that and thought wait... what if she was being sarcastic? :laugh:
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This is a No Sarcasm Zone.

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I’m discovering I suck at being a functioning human being.

I have had pulsatile tinitis (basically sounds like my heartbeat in my ears) and pressure headaches that I always just assumed was sinus pressure (with occasional dizziness and pretty subtle proprioception issues, i.e. I’ll start leaning to the side when standing still or bump my shoulder/arm on the side of the doorway I’m walking through) for the past three years. It seems to me that my symptoms actually worsen with stress and have been at their absolute worst the past month or two. I finally saw the ENT who suspected it was actually a neurological problem and was sent for a brain MRI. Welp, brain MRI came back clear and all I got was a single sentence from the nurse telling me it was “probably migraines”. The doctor had mentioned strong suspicion of idiopathic intercranial hypertension (IIH) which I unfortunately have the perfect signalment for and is a disease of exclusion. Based on my understanding, it can really only be “diagnosed” by lumbar puncture to detect high CSF pressure. But I guess we’re going with “probably migraines”. Today marks the fifth consecutive day of pressure headaches that are completely unresponsive to any OTC painkillers/NSAIDs/migraine pills and a resulting brain fog that makes it hard to be an efficient vet student and think to argue for further diagnostics for myself in the moment.

I can function at an acceptable level if absolutely necessary (I was able to get through surgery week and the first three exams of the semester successfully) but it isn’t a great quality of life. I tend to feel the worst in the mornings so have been missing a lot of class and then lack motivation to keep up with all the lectures afterward. On top of that, I’ll likely need to fit in more appointments with specialists to get this mess all sorted out.

In summary, my brain is just “evdhydueikdbdkdk” at a really bad time.
 
Emily Faith said:
I have had pulsatile tinitis (basically sounds like my heartbeat in my ears) and pressure headaches that I always just assumed was sinus pressure (with occasional dizziness and pretty subtle proprioception issues, i.e. I’ll start leaning to the side when standing still or bump my shoulder/arm on the side of the doorway I’m walking through) for the past three years.
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Emily Faith said:
The doctor had mentioned strong suspicion of idiopathic intercranial hypertension (IIH) which I unfortunately have the perfect signalment for and is a disease of exclusion.
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Well I apparently should go to the doctor
 
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cdoconn said:
Mmm... idk. I’m a huge advocate for One Health, but some of those fracture repairs are setting up for a lifetime of problems.

If I were, in two years, to go to a (human) homeless shelter and fix a human’s broken leg with a family medicine doctor “supervising” in the operating room, I’d likely get arrested and my license suspended.

But I’ve seen a lot of positivity about it saying that they would’ve been euthanized anyway, so why not let them do it. So now instead of being dead they had orthopedic surgery performed by residents with poor technique, gloves only-no gowns, and they’re obviously heroes for it.

They announced that they’re stopping the program but I’m just annoyed by it all. I might be reaching, but to me, it just feels like another jab at vet med that with absolutely no formal training regarding small animal surgery they felt qualified enough to do things that get referred to boarded veterinarians.

(I’m also dreadful at picking up sarcasm over the internet, so if your post was sarcastic, I apologize)
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cagelinervet.com

Area DVM launches “Veterinarians for Vagrants” to care for people with no health insurance

An area veterinarian, Dr Alex Smith has launched a new charity called "Veterinarians for Vagrants", with an aim of solving the health care crisis that has been
cagelinervet.com cagelinervet.com
 
mizchiefmanaged said:
Baby rant: someone backed into my huge-ass red truck in the in n out parking lot despite me honking constantly at her. Lady was super nice and apologetic. Truck is a bit dented so will be going in for plastic surgery.
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but you got to go to in n out so really it's a wash

signed,

californian at heart currently trapped in midwest
 
Stupid rant: I'm getting married next Summer...I know I should be ecstatic, but I can't help feeling a little sad. I still go home to my parent's house over breaks and weekends whenever I can and I think its just hitting me that all that is going to change. I love my fiancé and I absolutely want to marry him, but I think I'm just feeling really sad about how its going to change the dynamics with my family. And whenever we talk about the wedding my dad gets super emotional and that makes me more emotional. And also stressing that because I'm getting married this Summer and as a result will probably be unproductive in terms of vet med stuff I'll be ruining my chances of getting a residency.
 
nyanko said:
Which states? The DEA license is one thing but some states have separate things. MO was really confusing. I didn't have to renew my DEA license because I'm under the teaching hospital's, but we do have to apply for a BNDD license for the state itself which is separate.
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Way late, but NY, Mass, NJ and RI. NY is the only one that doesn’t have a separate controlled drug license. Realistically I’m probably only going to set DEA licenses for NY and Mass since that’s where I’ll probably be the most.
 
Elkhart said:
I’ve got several medications but haven’t had my prescriptions refilled by the psychiatrist in a while, so I may pay her a visit if this doesn’t start to improve in the next few weeks.
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Please do, Sandy, whether you think you might be improving or not 🙁 the meds and therapy are there to help you <3
 
Elkhart said:
I’ve got several medications but haven’t had my prescriptions refilled by the psychiatrist in a while, so I may pay her a visit if this doesn’t start to improve in the next few weeks.
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Your treatment plan is just as important for your wellbeing as my inhaler is for me! Keep on keeping on and go see her. She'll be able to help you talk through things to adjust whatever you need to and keep you on the up and up. <3
 
Elkhart said:
Sorry, I’m just now seeing this. Thank you, @genny.

I’m just frustrated that, even when life is comparatively going much better than it has been, I still fall into these depressive states. They cycle at least one or two times per year, without fail. It makes me feel even guiltier because it’s not like there’s anything terribly wrong going on right now; it’s just my brain being stupid. I’ve got several medications but haven’t had my prescriptions refilled by the psychiatrist in a while, so I may pay her a visit if this doesn’t start to improve in the next few weeks.

I’ll get through it, I’m sure, as I’ve gotten through it many, many times before when my life situation was significantly worse than it is now. Just gotta find the small things worth sticking around for and cling to them with all my might.
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This is nothing much, but, keeping a happiness calendar is something I do to help me cling to the good things even on really terrible crappy days. I just make a short list at the end of every day of things that made me smile that day. It could be something as important as a birthday, wedding, or holiday party, or something as simple as listening to the leaves crunching beneath my feet as I walk to my car, lighting a candle, or honestly even cleaning my room.

Obviously it isn't a replacement for depression or anxiety meds, which you and your psychiatrist will figure out together when you visit, but it helps keep me centered and remember that even on the very worst day of my life I can find something I am grateful for.

I'm rooting for you Elkhart! You deserve happiness.
 
Screw my beta receptors!! :rage:

ETA for clarity: I have both essential tremor and asthma. Every day I get to weigh the pros and cons of beta blocker vs beta agonist. Tonight, beta agonist won.
 
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mypetmoose said:
This is nothing much, but, keeping a happiness calendar is something I do to help me cling to the good things even on really terrible crappy days. I just make a short list at the end of every day of things that made me smile that day. It could be something as important as a birthday, wedding, or holiday party, or something as simple as listening to the leaves crunching beneath my feet as I walk to my car, lighting a candle, or honestly even cleaning my room.
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I do this too! Helps me a lot on days where I feel like nothing is going right.
 
My blood pressure is... unpredictable. I fainted this morning and smashed my head on the corner of a wall. Was out for 10 mins, and my neck and the whole left side of my body feel very messed up. I've had several severe concussions and I'm pretty sure I need stitches... currently having a coffee to boost my blood pressure before heading in for assessment. Not how I'd envisioned starting my day!
 
Squeaksmom said:
My blood pressure is... unpredictable. I fainted this morning and smashed my head on the corner of a wall. Was out for 10 mins, and my neck and the whole left side of my body feel very messed up. I've had several severe concussions and I'm pretty sure I need stitches... currently having a coffee to boost my blood pressure before heading in for assessment. Not how I'd envisioned starting my day!
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That's bananas! Have you had it checked out?
 
My job is on-call and my first shift was yesterday. During training I met with another tech who said in the year since she started, there have only been two calls at 11:50 (we are off duty at 12)

I went to bed at 9:30 worried I would get a call as soon as I was out. Instead I was comfortably asleep, heard my phone, thought no way could it still be before midnight, but sure enough, my first call comes at 11:45 :dead:
 
Squeaksmom said:
My blood pressure is... unpredictable. I fainted this morning and smashed my head on the corner of a wall. Was out for 10 mins, and my neck and the whole left side of my body feel very messed up. I've had several severe concussions and I'm pretty sure I need stitches... currently having a coffee to boost my blood pressure before heading in for assessment. Not how I'd envisioned starting my day!
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Oh wow I hope your day gets better 🙁
 
CoffeeQuestionMark said:
That's bananas! Have you had it checked out?
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Honestly, only sort of. I've been fainting every few months since my teens, and no doctor's been overly concerned before. I've gotten the odd ECG, but most take one look at my blood pressure and shrug. Today it was borderline high, so this doc... was more worried.

I came home with sutures in my forehead, and apparently have whiplash and a(nother) concussion. There's no "obvious" fracture to my left patella, but it's questionable so my rads have been sent in for a radiologist's consult. Bloodwork and ECG are normal. He also called in a cardiology consult on me as an outpatient... I should get a call soon. Because apparently fainting every few months is "abnormal." 🙄 (so now they tell me...) At this point, what's one more specialist? (this will be #6)
Coopah said:
Oh wow I hope your day gets better 🙁
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Thanks! The unit clerk was muttering that she wanted to choke someone, she was so frustrated by computer issues. I volunteered to be the victim. With the way my day was already going, what the hell. And I was already in the ER....
 
Squeaksmom said:
Honestly, only sort of. I've been fainting every few months since my teens, and no doctor's been overly concerned before. I've gotten the odd ECG, but most take one look at my blood pressure and shrug. Today it was borderline high, so this doc... was more worried.

I came home with sutures in my forehead, and apparently have whiplash and a(nother) concussion. There's no "obvious" fracture to my left patella, but it's questionable so my rads have been sent in for a radiologist's consult. Bloodwork and ECG are normal. He also called in a cardiology consult on me as an outpatient... I should get a call soon. Because apparently fainting every few months is "abnormal." 🙄 (so now they tell me...) At this point, what's one more specialist? (this will be #6)

Thanks! The unit clerk was muttering that she wanted to choke someone, she was so frustrated by computer issues. I volunteered to be the victim. With the way my day was already going, what the hell. And I was already in the ER....
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Have you heard of POTS?
 
dyachei said:
Have you heard of POTS?
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I hadn't, so I just googled. Apparently it's only diagnosed when orthostatic hypotension is ruled out, and I've been diagnosed with orthostatic hypotension. So I'm thinking not that unless they got the first diagnosis wrong? (which is obviously possible!) But my smartwatch has a heart rate monitor, and it says my heart rate only went as high as 92 in the whole episode (from when I got up to when I came to), so not crazy high. I guess we'll see what the expert has to say when he/she weighs in....
 
Squeaksmom said:
I hadn't, so I just googled. Apparently it's only diagnosed when orthostatic hypotension is ruled out, and I've been diagnosed with orthostatic hypotension. So I'm thinking not that unless they got the first diagnosis wrong? (which is obviously possible!) But my smartwatch has a heart rate monitor, and it says my heart rate only went as high as 92 in the whole episode (from when I got up to when I came to), so not crazy high. I guess we'll see what the expert has to say when he/she weighs in....
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Most people do the poor man's tilt table test. Measure your BP when laying down then stand up and measure it again. You need a real tilt table test to rule it in. But your symptoms sound very similar to my friends with it.
 
Squeaksmom said:
I hadn't, so I just googled. Apparently it's only diagnosed when orthostatic hypotension is ruled out, and I've been diagnosed with orthostatic hypotension. So I'm thinking not that unless they got the first diagnosis wrong? (which is obviously possible!) But my smartwatch has a heart rate monitor, and it says my heart rate only went as high as 92 in the whole episode (from when I got up to when I came to), so not crazy high. I guess we'll see what the expert has to say when he/she weighs in....
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Reading more, it doesn't really align with what I'm experiencing....
 
Squeaksmom said:
My blood pressure is... unpredictable. I fainted this morning and smashed my head on the corner of a wall. Was out for 10 mins, and my neck and the whole left side of my body feel very messed up. I've had several severe concussions and I'm pretty sure I need stitches... currently having a coffee to boost my blood pressure before heading in for assessment. Not how I'd envisioned starting my day!
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I have had fainting spells as well, including one where I nailed a counter top and lost two of my front teeth. That was my 4th fainting spell over about 5 years, and then I fainted in class a year later. I regularly have BP of around 100/60, and a heart rate of 60. We did a tilt table test and I was diagnosed with vaso-vagal syncope and chronic hypotension. I 100% recommend even just trying out some cardiac consults if you can. Since doing the tilt table test, I know that I'll faint if I stand for 18 minutes. I haven't had a fainting spell since cause I know what to look for and how to avoid it in the first place.
 
I was literally scared to get out of bed this morning because it might happen again. I feel like I was literally beaten. But Wednesday labs are mandatory without an excused absence from the Associate Dean, Academic, and he and I don't have a great history, so....
 
Squeaksmom said:
I was literally scared to get out of bed this morning because it might happen again. I feel like I was literally beaten. But Wednesday labs are mandatory without an excused absence from the Associate Dean, Academic, and he and I don't have a great history, so....
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If you feel any sort of weird, sit down. Literally. If you get dizzy, light headed, whatever, just sit. Whatever is on the ground is better on your butt than on your face.
 
batsenecal said:
If you feel any sort of weird, sit down. Literally. If you get dizzy, light headed, whatever, just sit. Whatever is on the ground is better on your butt than on your face.
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Always good advice! Fortunately or unfortunately this is my fourth concussion, so even though it sucks I have a fair idea of how to handle it. I actually walked into the ER yesterday and told triage that I had a concussion and whiplash. She assessed me quickly and was like "yes, yes you do!"

When your brain is scrambled you don't always think of things like medical notes. First thing this morning I talked to the covering course coordinator (the actual course coordinator is out of the country), who also happens to be leading one of the lab sections today. Showed her the stitches and bump on my head and told her that I wasn't sure how my reaction time was going to be with the horses. I suspect I also have a bit of a "lights are on but nobody's home" look! She immediately excused me from lab.

The sutures in my forehead look sketchy enough that one of my classmates has already offered to redo them if they dehisce. <sigh>
 
Squeaksmom said:
Always good advice! Fortunately or unfortunately this is my fourth concussion, so even though it sucks I have a fair idea of how to handle it. I actually walked into the ER yesterday and told triage that I had a concussion and whiplash. She assessed me quickly and was like "yes, yes you do!"

When your brain is scrambled you don't always think of things like medical notes. First thing this morning I talked to the covering course coordinator (the actual course coordinator is out of the country), who also happens to be leading one of the lab sections today. Showed her the stitches and bump on my head and told her that I wasn't sure how my reaction time was going to be with the horses. I suspect I also have a bit of a "lights are on but nobody's home" look! She immediately excused me from lab.

The sutures in my forehead look sketchy enough that one of my classmates has already offered to redo them if they dehisce. <sigh>
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I'm pretty sure my forehead is dehiscing. And that my patella is indeed fractured. This just keeps getting better....
 
So the good part is that I have a medical note now. But the first day I'm allowed to try to come back we have a midterm first thing :/
 
And the kicker is... I might wonder if I was just acting crazy, but multiple classmates have had the same experience. Like, some really bad stories of things getting ignored because we are students.

I understand that we get good discounts on services but 1) we pay a ****ton of $ in tuition compared to a lot of other schools so it's not like we're not paying for part of the hospital already and 2) just because we get a break on the bill doesn't mean our pets aren't worth what clients' pets are worth 🙁
 
PippyPony said:
And the kicker is... I might wonder if I was just acting crazy, but multiple classmates have had the same experience. Like, some really bad stories of things getting ignored because we are students.
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Unfortunately that’s the typical experience with some teaching hospitals. Student pets get the shaft. Sometimes they think they’re doing you a favor by cutting corners. Sometimes it’s really that your pet is just on the back burner. Though I will say, the last few chronic rhinitis/snuffler kitties I sent for referral were all talked out of advanced imaging as well, so it may not be just you. And unless you are working with derm, many clinicians in other services don’t really know how to read/interpret ear cytologies.... interns/residents/attendings in most services have limited experience managing chronic skin/ears. I’ve had clinicians ask me as a student what to do with ear cytologies after I went through my derm rotation... I went through a similar experience as a student where my concerns kept getting blown off and no one would run testing that I had asked for on my cat (cause what do I know, I was just a lowly second year). Turns out I was right when my pet was finally tested several months later, to the point where the internist on her case pulled me aside when I was a 4th year and apologized that my cat had ended up “a victim of academic medicine”...

What really gets me is that the experience continues as an alum when you are a fully paying customer. My pets always seem to get the shaft... I almost dread taking them to the teaching hospital. Overnight ER with interns can be the worst (and my expectations are set low - as long as they don’t make my pets worse overnight and provide supportive care that make any sort of sense I’m happy). I bring over a hard copy of labs and relevant records and hand them in person as well as email them to the ER AND general email... and somehow they aren’t looked at by the overnight staff nor the transferred service the next day when I finally get an update at 1pm that literally nothing had been done despite having been charged for hospitalization and having given a crate Blanche on care and stated “do whatever my pet needs with initial treatment and minimal database/rads/AUS, finances are not a concern.” Nothing as in my pet is even drier now than when I first admitted them because fluid therapy was really not addressed, despite having a “hemorrhagic gastroenteritis” presumptive diagnosis no gastroprotectanta are started, and despite PCV having dropped >30% since 2 days ago in a different pet admitted for acute weakness, no one bothered to notice because ‘mild anemia in a cat is just meh’ and go “oh...” when I point out that while a PCV of 28 isn’t horrible in an old cat, it was 44 just two days ago in the labs I personally handed over and emailed last night when this new PCV was taken. My pets seem to just get shoved in a cage to be “dealt with later” after everyone else. When I’m being patient about communications because I know the service is busy and I say I don’t need to be the first call after rounds, I don’t mean my pets can be completely neglected for 20hrs either... And then they often don’t get properly transferred over to the appropriate service (they stay ‘ER patients’ and the intern goes and gets informal consults with other services) so when things continue to go wrong, I don’t have anyone to follow up with. With my last pet, in her last month of life after admitting her for initial workup at the teaching hospital, I had to shuffle her to two other referral hospitals emergently because no service would take responsibility for her and schedule a follow up as further problems arose. I was told she could not see cardiology at the main hospital or the satellite clinic for 2 months even though her BNP shot up from 100 to >900 within s week (heart wasn’t even her primary problem), despite the fact that she had been a patient of the cardiology service and has had at least 4 echos with them to follow her slowly progressive HCM. They still just said “nope, sorry” when I mentioned she’s been serially monitored by cardiology so that when something like this happened she’d have a regular cardiologist AND that I’m worried she is dying within the next couple of weeks and cannot wait 2 months. Was also denied follow up with internal medicine. This pet had a huge file at the teaching hospital and has had multiple hospitalizations, multiple ultrasounds, tons of labwork, multiple echos, and endoscopy amongst other things done at the teaching hospital over the past several years. It was heartbreaking to be told “she’s not really a patient here so we can’t do anything for you” 5 days after being discharged from being hospitalized in the ICU on telemetry overnight. I ended up putting her down at home after needing to start fresh with an internist 45 min away, then rushing her emergently to a cardiologist and criticalist an hour away where she needed a transfusion, and still wonder if we may have been able to save her had she gotten better care initially at the teaching hospital. Like I literally spent $2k overnight and nothing was accomplished even though I wanted anything and everything that may have possibly helped. They wanted nothing to do with her and they wouldn’t even give me someone to speak with to come up with a plan such that I had to call around elsewhere to find someone who gave a ****. I never got to a definitive diagnosis for why she was going downhill... I had to presume cancer so I could live with myself. Hard not to feel bitter after this experience. I hate to be that “there should be a wing named after my pet” kind of person, but I feel like my cat deserved a little more consideration.

When my clients tell me they don’t want to go to the teaching hospital due to bad experiences, it’s really hard for me to defend them though I do because that’s in the best interest of the patient. When I send patients through the ER, I often have to give the disclaimer that the clients have to be patient especially overnight as the teaching hospital can be a hot mess, but to trust the process and go with it as the pet will eventually get the care they need once they are seen by the appropriate service.

One thing I’ve learned though, is that as a vet it’s really easy to do this myself for my staff’s pets. It’s not a conscious thing. But when you do just informal consults or just allow running random diagnostics, it’s easy to not keep full records or due diligence with follow up. So I have made it a point to put in a conscious effort to make sure that staff pets get the full attention that any other patient gets, including record keeping. It seems silly to put in a communication log of things you discuss with staff about their pets throughout the day, but it’s important esp if they get referred elsewhere later or for insurance purposes.
 
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@PippyPony who was it not running cytology or refusing your CT request? I’d go to the head clinician and say “please schedule kitten for CT next Monday. Do the ear cytology while he’s out.”

I agree with Minnerbelle re: staff pets and it isn’t fair. I make a conscious effort to do a thorough exam, write complete and to offer everything, even if they decline. Keep advocating for yourself and if they won’t listen, go elsewhere.
 
@Minnerbelle I am so incredibly sorry about your experiences with your cats. No one should have to feel neglected like that. I was actually saying "no!!" out loud when I read some sections of your post 🙁
It was especially brutal to read how you were trying to be understanding of the demands on the system, but that kindness got abused instead of appreciated.

Like you, I can also see how those situations could happen from the other side and I do empathize with that...but it's not an excuse and my heart breaks for you and your pets. 🙁 Honestly I am glad to have this discussion prior to clinics+internship because I hope I can remember it when I am exhausted and use it to drag up some energy reserves. Thank you for sharing.

Minnerbelle said:
Though I will say, the last few chronic rhinitis/snuffler kitties I sent for referral were all talked out of advanced imaging as well, so it may not be just you.
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Sigh. It makes me want to do some kind of a study tbh.

Granted I may be jumpier than your average bear about sniffly cats because I have had three very personal experiences with nasal tumors in cats (despite their purported rarity), and four experiences with being told that dyspnea is just a cold or asthma...and then oops nope it is cancer and they can't breathe and are dying an awful death.

So yeah, I know this cat is just a kitten and thankfully neoplasia is at the bottom of the ddx list this time... but a non-infectious etiology is not impossible either.

Minnerbelle said:
And unless you are working with derm, many clinicians in other services don’t really know how to read/interpret ear cytologies.... interns/residents/attendings in most services have limited experience managing chronic skin/ears. I’ve had clinicians ask me as a student what to do with ear cytologies after I went through my derm rotation...
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Man, this year I am beginning to realize how lucky I am for the job I had before school. I worked for a dermatologist who also had GP associates at her clinic, and so I think we all got spoiled on derm stuff.

Ear cytologies are SO easy, cheap, and fast ...and they are high reward in terms of treating painful pets. It felt like we ran them for almost every other exam, especially because if you're quickly swabbing an ear anyway as part of a comprehensive PE, why not just roll that qtip around on a slide first instead of chucking it in the trash (or even just save the qtips if you don't want to use up a slide). Then if it turns out the history indicates some head shaking, itchiness, what have you...then bam, you have your sample that you can stain & get a tech to review, and haven't done anything more invasive than what you would have already done in the first place.

From talking to my classmates recently, they didn't see much of it in GP either, though. So I guess I am turning into a derm evangelist; my old boss would be thrilled haha
 
PippyPony said:
From talking to my classmates recently, they didn't see much of it in GP either, though. So I guess I am turning into a derm evangelist; my old boss would be thrilled haha
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This is so weird to me since 40% of my caseload is easily derm stuff - ears and skin and allergies. And I’m in GP. Maybe because I ask the right questions? Lots of owners won’t mention the foot licking or ear scratching because it’s “normal” for their pet.

Sorry you’re going through a rough time with your kitty, Pippy. I second TRH’s suggestion of a discussion with the head clinician about why your requested diagnostics aren’t being run.
 
PippyPony said:
Granted I may be jumpier than your average bear about sniffly cats because I have had three very personal experiences with nasal tumors in cats (despite their purported rarity), and four experiences with being told that dyspnea is just a cold or asthma...and then oops nope it is cancer and they can't breathe and are dying an awful death.

So yeah, I know this cat is just a kitten and thankfully neoplasia is at the bottom of the ddx list this time... but a non-infectious etiology is not impossible either.
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Well that was the frustrating part. I’ve had some complicated rhinitis patients that had other things going on so wanted to really rule out polyps/tumors/FB (esp when it seemed unilateral) and the owner was up for it. It just makes me look really bad for offering the referral.


PippyPony said:
Man, this year I am beginning to realize how lucky I am for the job I had before school. I worked for a dermatologist who also had GP associates at her clinic, and so I think we all got spoiled on derm stuff.

Ear cytologies are SO easy, cheap, and fast ...and they are high reward in terms of treating painful pets. It felt like we ran them for almost every other exam, especially because if you're quickly swabbing an ear anyway as part of a comprehensive PE, why not just roll that qtip around on a slide first instead of chucking it in the trash (or even just save the qtips if you don't want to use up a slide). Then if it turns out the history indicates some head shaking, itchiness, what have you...then bam, you have your sample that you can stain & get a tech to review, and haven't done anything more invasive than what you would have already done in the first place.

From talking to my classmates recently, they didn't see much of it in GP either, though. So I guess I am turning into a derm evangelist; my old boss would be thrilled haha
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Derm is hit or miss depending on how vibrant the derm service is, and how involved they are in teaching students. And in GP, how the clinicians at that hospital was trained. I got super lucky and had a great teaching service as a student, and also worked in a hybrid hospital with a dermatologist on site so am pretty comfortable with skin/ears. But man... my current boss is awful. Doesn’t like me performing ear cytologies (dunno why because I charge for it... and with rechecks each ear case I see can generates a good $100-150 more than the way he manages it. I’m straight salary so I have 0 incentive to do this extra work if I didn’t think it was worth it). And tells me that the reason why my patients get pseudomonas infections is because they’re not well managed like his patients are... and somehow he knows his patients don’t have rods without cytologies. What’s funny is I end up seeing my boss’s ear patients and the owners end up super glad to have someone who will actually address the pet’s issues rather than squeezing Claro in the ears every couple months.
 
that redhead said:
@PippyPony who was it not running cytology or refusing your CT request? I’d go to the head clinician and say “please schedule kitten for CT next Monday. Do the ear cytology while he’s out.”
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Part of the problem is that there isn't a single point of contact, which I think is a function of how student cases get handled at our hospital (e.g. is unique to this case, not reflective of general state of things, nor any oversight on behalf of any one person). I think I will try an approach like this, thank you for the advice.

...Should also clarify that they didn't refuse diagnostics outright or anything like that -- I asked about scheduling a CT and they told me how to do that if I want to. And I empathize with the doctors who have seen him, because he's not critical and magically seems to get better whenever we step into the hospital, so I am sure I seem like I am overreacting and/or looking for things that are not there. Maybe they are also trying to approach this with less hand-holding for my benefit and are assuming I will push for things I want done because I am a student.

Again, I'll probably delete these posts later because I don't want to demonize our hospital or the individuals involved -- I am frustrated right now so my statements are clouded by that emotion & leaving a one-sided rant out there in the ether would be unfair to people who I actually respect a lot.
 
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