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Thursday, October 8, 2009

"Dr. Layperson"

I was chatting on an online veterinary site recently, and several people were comparing notes about various crazy client complaints. One of the big things that comes up is clients who think they know better than the doctor, or somehow think that medicine is easy. Just this week I had a client bring in her shih-tzu puppy who was having diarrhea and vomiting. I had my tech present a treatment plan which included checking for intestinal worms, parvo, and giardia. The client asked her why I couldn't tell what was wrong with her dog. Umm....that's why I want to run the find out what's wrong...Apparently the person thought that I could figure out the problem simply with an exam, even though I had explained the possibilities to her before I stepped out of the room.

A few years ago I had a person (not a regular client) come into the office wanting to purchase Hill's K/D. This is a veterinary-only diet designed for pets in kidney failure. Because of its low protein levels (which are beneficial with renal disease) it's not recommended for pets with normal kidney function. Therefore we don't let anyone just walk in and pick up one of these diets without a good reason or authorization from another vet. He said that his dog had kidney disease and therefore he wanted the diet. I asked him why he thought this and if another vet had diagnosed kidney disease. He said no, he hadn't been to another vet and he knew the dog had kidney problems because it was urinating a lot. I explained that kidney disease couldn't be diagnosed without blood and urine tests and that there were several other problems that would cause an increase in urination (diabetes, urinary tract infections, Cushing's disease, etc.). He began to argue with me that he just knew his dog had problems with its kidneys and insisted on the food. I refused without any tests being run. He started yelling at me and became irate. I still didn't let him have the food, and he stormed out. Somehow his opinion based on a single symptom was better than my years of training, knowledge, and experience.

Believe it or not, that's not uncommon. I have had many people take the advice of breeders, store clerks, and friends over that of a veterinarian. These laypeople seemingly have greater skills and knowledge than a licensed and experienced doctor, or so certain clients appear to believe. There is an awful lot of "Doctor Layperson" syndrome out there, and it's frustrating to real doctors. I'm the first to admit that I don't know everything, and that there are other doctors who are smarter and better than me. But I sure as heck know more about immunology and vaccinations than a breeder and know more about flea life cycles and nutrition than the guy stocking at PetCo. In the end, I think it comes down to people believing what they want to believe. And to these people a medical degree means nothing if I'm not telling them the "right" things.

Thankfully these people are in the minority, though it is a larger minority than I like to see.