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Monday, July 22, 2013

Instant Expert....Just Add Textbook

Any clients who read this post are in for a shock.  Your vet doesn't know everything.  *GASP*  No matter how much you love your vet or think they walk on water, they don't know all there is about every disease out there.  "But every time I come in he/she always seems to knowledgeable!"  Ah, but there's a reason for that.


When I go to conferences the busiest vendors are always the textbook publishers.  These books are not directed at veterinary students, but instead are bought by experienced practitioners.  Every good vet has a decent library of books in their office, many of which are coming apart at the binding because of being opened so many times.  One of the things I emphasize to new graduates is that there is no shame in looking things up.  Every vet does so daily.

Often right before we go into a room.

A few days ago I had a dog come in for a discussion about Addison's disease.  This is a disorder where the body doesn't produce enough steroids and can be life-threatening.  Thankfully it's a very treatable disease with and excellent prognosis.  But I don't see a case every week, so the small details were a bit fuzzy.  In fact, it's been a few years since I've had a confirmed case come to me.  My memory remembered the basic lab values (decreased sodium and increased potassium, often with kidney values out of whack), the very vague symptoms (lethargy and weakness), the confirmatory test (ACTH stimulation) and general treatment (steroid supplementation).  However, the specifics of the disease escaped me, especially specific values and dosages.  So before I went into the room I pulled out one of my textbooks and read the section on Addison's disease to refresh my memory.  By the time I went into the room I could talk to the clients like I diagnosed this disease every day.

This is in no way deceitful or dishonest.  There is so much to know in medicine that nobody could possibly keep all of the information in their memory.  One of my associate doctors has a seemingly encyclopedic knowledge of even obscure veterinary diseases and treatments.  Sometimes I shake my head at the facts that she easily spouts.  Yet even she looks things up daily.

Yes, talking about this is a bit like pulling back the wizard's curtain in Oz.  But I want clients to know that doctors aren't all-knowing, despite our best intentions.  And I want veterinary students to know that having to look things up doesn't mean that you aren't a good doctor.  Sometimes all of us need a little help.