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Tuesday, September 15, 2009

Twenty-First Century Medicine

Yesterday's entry has made me think more about where we have come in veterinary medicine. I have been in practice for over 12 years, but have been around the profession for about 25. I've seen a lot during that time, and can imagine what retired vets think. Technology can be great, and has helped improve the quality of medicine and treatment. Here are a few things that really hit me on this topic.

Radiology--Decades ago it was uncommon for a vet to have x-ray equipment in their practice. Then it became routine, and eventually automatic processors were created that developed films quicker and easier than hand-dipping them (anyone remember that?). Now we have digital radiography. This is common in human medicine, and is increasing in veterinary medicine. Digital "films" eliminate the need for physical films and processing fluids. You have an instant image, and can retake it quicker if it's not quite what you want. The doctor can also magnify any portion of the image and change the contrast to make it easier to see something. You get faster, better images. I expect this to be the norm in about 10-20 years.

Ultrasound--Once used only by specialists, this equipment is now priced in the range that a general practitioner can afford. There is more training needed to use it properly, as the images take a fair bit of interpretation, but there are classes on this at any major continuing education meeting. Ultrasound is much better at imaging soft tissues than x-rays, and can give you and idea of what is going on inside an organ. I forsee this being indispensable to a vet within a generation, like basic radiography is now.

Laser surgery--No longer part of science fiction, it's uncommon but not rare to have many surgeries performed using a surgical laser rather than a scalpel. There is debate as to whether or not it is that much better than standard surgical methods, but those who use it are very impressed with pain control and healing. I don't think this will ever be wide-spread, but it will continue to grow in popularity.

Vaccinations--We don't normally think of a vaccine as "technology", but there is actually a lot of high-tech science involved. Over the last several decades vaccines have changed radically, now using only parts of the bacteria or virus, including sections of DNA. Vaccines have become safer, more effective, and longer-lasting.

Computerized records--Many practices are going "paperless", keeping all medical records on their computers. This means you never have to worry about handwriting or lost files, and it makes it easier to store and search. You can also pull up a patient's history from anywhere in your practice, save digital images, and so on. Very high-tech practices have laptop-sized wi-fi pads that the vet can carry around and use to access the computer system. All of medicine is moving in this direction, and within a decade paper files will likely be the exception rather than the rule.

The Internet--I remember many years ago when the vet I worked for did cardiology consultation by attaching a phone receiver to a special box and sending ECG signals over the telephone lines. Now we can send digital images and videos of ultrasound over a high-speed internet connection to any vet or specialist in the country. We also have several veterinarian-only web sites where we can exchange information and consultations within seconds. Vets are no longer limited to discussing cases within their practice or their city. They have world-wide information and colleagues at their fingertips, allowing better exchange of information and therefore much higher levels of patient care.

Now, I want to be clear that technology is only a tool. It will never take the place of a strong education, experience, and good judgement. But these tools allow us a higher standard of care than even dreamed of a 50 years ago. I'm excited to see where the profession will be by the time I retire in another 25-30 years.

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