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Saturday, July 9, 2011

Physician Vs. Vet

At the beginning of this past week I saw a dog for a health certificate prior to travel.  The client is moving from the US to Germany and is taking her dog with her.  She received her international health certificate  previously and just needed a more recent interstate one for flying within the US.  This was no big deal and we handled it quickly, examining the dog and issuing the certificate.  The dog was in good health so there were no issues.

Today the client calls, saying that the dog had discharge from its eyes and wondering if I had looked at the eyes.  It was a very busy day for me, so I relayed information through my staff who were talking to her on the phone. I remembered the case and said that I had indeed looked at the eyes (as I always do in my exams) and there was nothing wrong at the time.  My staff is trained that we don't issue medications without an exam, and explained this to the client.  She was not satisfied and told the receptionist "I'm a physician," which was probably supposed to open magic doors of compliance on our part.  I stood my ground and said that I still wouldn't issue medications without an exam since the problem hadn't existed a few days ago.  My office manager got on the phone and continued to explain to the client that we needed to see the pet first.  Then the question is brought to me "If you were going to prescribe something, what would it be?"  I could see right away that the client was trying to figure out what medicine she could give to her pet without being seen. Eye discharge could be the result of an infection, allergies, a corneal abrasion and several other things, all of which are treated differently.  So I couldn't give a specific medication without seeing the pet unless I was going to simply guess, and I'm not about do to something like that.  The client told my manager that she had too much to do as she was leaving the country tomorrow and couldn't take the time to bring her dog in to be seen.  She finally said "I'll just write a prescription for something" and hung up in a huff.

Sometimes the arrogance of human medical professionals astounds me.  I have never presumed to know more than my own doctor or pediatrician, and rely on their knowledge and advice.  I respect their training, position, and time.  Unfortunately I feel that some physicians and nurses feel that veterinarians aren't as smart or as well trained as they are, and see us as somehow not really doctors.  I have seen an attitude of superiority from many of these clients (though not all).  What really gets to me is that these clients should be the ones least likely to cause problems, as they should know better and understand.

For example, let's take this most recent client.  As a physician herself, what would have happened if I called her and said "I have an infection and I need you to give me some medicine.  Yes, I know you just saw me last week and I was healthy but you must have missed something and I have this problem now.  I'm a vet so I know you just need to prescribe me something."  Any responsible human doctor would say "no way" as quickly as I did.  Sending out medications for a problem that you haven't seen or diagnosed is poor quality medicine at best and potentially malpractice at worst.  Second, this client assumed that she will know as much about medical interactions with pets as she does about humans.  I can assure you that though many medicines are used between species, there are others that can be downright dangerous.  I always defer to my own doctor when it comes to human medications and don't presume to know the same things about humans as I do animals.  Thirdly, a human doctor is legally able to make diagnoses, perform treatments, and write prescriptions for only a single species:  Homo sapiens.  Though I doubt a pharmacy would really check, it is actually illegal for a human doctor to write a prescription for an animal.  Conversely I am able to write prescriptions for any animal except humans.  If I prescribed medications for myself or my family I would be breaking the law and could even loose my license.  A knowledgeable and responsible doctor would know this and wouldn't seek to circumvent the law.

Unfortunately there's not much we can do about situations like this.  Maybe some physicians, nurses, or other human professionals will see this and realize that vets are just as intelligent and highly trained as they are and give us the respect they expect be given to them.