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My Changing Profession by: Dwain E. Zagrocki D.V.M.
It has been three weeks since I have been able to practice my profession - Mixed Animal (large and small animal) Veterinarian. Over my twenty-four years of practice nothing has kept me away longer, and some of those things are much more important in the scope of human existence. Marriage, births, holiday celebrations and even deaths have never barred me from my patients for this length of time. My back, more specifically my spine at T-11 - L-1; L-2 - L-3; L-3 - L-4; and L-5 - L-6 decided for me that I had to put my practice of profession on hold. I have already passed through the denial, anger, and acceptance phases of my recovery. I am greatly looking forward to returning to my hospital and patients after some additional treatments and physical therapy. During my recovery I have had the opportunity to slow down and examine my quarter-century in this great profession, “Veterinarian.” Often practice moves at such a rapid rate, like a car speeding down the interstate, that we, the practitioners, fail to see the surrounding landscape - the changes occurring in our profession. Let alone do we take the time to evaluate if those changes are for the better or the worse. |  |
One of the many changes general practitioners, such as myself, have experienced is the incorporation of more advance diagnostic tools at our level of patient care. Advanced machines that offer superior anesthetic monitoring not only saving many lives but, in addition allows general practitioners the ability to offer diagnostic and surgical procedures to riskier (because of heath or age) patients. I have enjoyed using diagnostic ultrasound in my practice. Back in veterinary school twenty-five years ago ultrasound was like Aunt Mae's prize piece of plastic wrapped furniture when I was a kid - okay to look at but if your tail end got too close to it you were fixing for a yelling. My trusty AKOA ultrasound has served me well whether I was evaluating ovarian cystic follicles or following the course of treatment of damaged tendons in horses. In my small animal practice I have greatly marveled at its ability to discover certain cancers and evaluate organ structural function. Just like in the human field, it is usually a good, lighthearted moment letting people see and witness the miracle of life: yet to be born fetuses. Moreover, and more practical, our ultrasound is an essential tool to determine if fetuses are heading towards fetal distress and helps determine if and when a C-section should be performed. In-house laboratories allow us to make decisions in twenty minutes that at one time took one to three days to make. Computerized x-ray machines that were state of the art twenty years ago are now rapidly being replaced by digital x-ray equipment capable of greater detail, storage, and disbursement. Clear radiographic images can now easily be emailed to the other side of the world if necessary. Computers in general have changed everything, including recordkeeping. They have enhanced lab capabilities and have aided in the manufacture of newer medications. In addition, computers have provided quick access to information for both doctor and client. Too bad not all the information is correct and unbiased. |
How we work as veterinarians is quickly changing. Today “Relief” veterinarians and “Part Time” veterinarians are common, not so fifteen to twenty years ago. Many veterinarians opt now to work for large corporations and multi-facility groups versus seeking independent ownership of a veterinary hospital. There has been a steady decline in mixed animal practitioners, such as myself. I have even heard colleagues refer to us as veterinary medicine's dying breed. All of this is in line with the march towards specialization, following our human counterparts.
Our clients are also changing. You are more Internet proficient and knowledgeable. Many have researched and purchased varying animal insurance policies that potentially increase the diagnostic and treatment options that we can offer. The importance of companion animals in our lives has now been definitively documented. An understanding of the “human - companion animal bond” is essential if one wishes to be a good doctor.
The way general practitioners address medicine has also changed. We have moved from a “reactive medical” viewpoint to a “proactive medical” viewpoint. The value of prevention of disease and maintenance of health are now foundations of any good practice. Conservative practitioners such as myself are now much more likely to incorporate nutrition into our treatment plans to fight disease and maintain health. Our view of how to diagnose and treat has become more integrated. Many, if not most, have added physical therapy and even the induction of alternative medicine into our arsenal to maintain health and fight disease. One change in my profession that I am particularly proud of is the recognition of the importance of how pain affects our patients and how to best deal with it. Twenty years ago few patients received post elective surgery pain medication. Now it is a mainstay of good practice everywhere.
So, with all this rapid evolution in the profession, what are the benefits and downfalls? Advances in equipment have no doubt led to better diagnostic and treatment capabilities. In addition, the rise of specialization has given the veterinarian the ability to offer, through referral, many diagnostics and treatments that are on par with human medicine. The problem is the costs. Better equipment with the price tags of twenty, fifty or one hundred thousand dollars can skyrocket a practice's debt and the burden is passed to the consumer—You. That said, my profession still does better in the cost-to-service-ratio than our human counterparts. Analyzing the costs of services I have personally incurred over the last month; I have found them to be 30% to 40% more expensive than those that would be incurred with the identical services in the veterinary field. Blurred in this observation lie lessons from which I wish my human colleagues could learn. Specialization brings many great advantages but it can also bring laziness. It can be used as an excuse to not maintain expertise in many procedures that a generation ago would consider routine. The problem, if our clients can not afford treatment at a specialist, our new veterinarians are less inclined to offer treatment solutions at the level of general practice. A nightmare I have is that this trend will, in the near future, lead to the increase of euthanization of patients due to the lack of ability to provide reasonable and effective care at the level of general practice.
I am concerned that as private practice ownership decreases and as practitioners, however devoted, devote less time to their profession, the veterinarian's concern for and position in his community will be diminished. The place in one's community is one of the greatest gifts our past generations of veterinarians has passed on to us. As I look at my future days of practicing now numbering less than those that have passed, I would like to warn my younger colleagues to not neglect the basic principles that have made this a great profession. A good practitioner is engaged in his or her community. A good practitioner must be prepared to offer meaningful options to their clients who may not be able to afford the “A” treatment. A good practitioner must resist the economic rhetoric that glorifies the benefits of being the most expensive vet in town. Yes, veterinarians need to charge for and be compensated for the services they provide; and their services are still a bargain as compared to those offered in the human field, but an increasing number, in my opinion, engage in what I call “show over substance.” They justify their much higher-than-average fees on what they try and “sell” to the client community as their superior service or expertise when in reality they offer nothing more than their colleague down the street. Even if only a small percentage of doctors practice this deception it will, in time, be discovered by their clients who thankfully are much more engaged in the medical and economic care of their pets and livestock.
In closing, I have seen many changes in my profession over the last quarter of the century. No doubt the evolution of the practice of veterinary medicine will continue. The benefits and level of care we can provide our patients continues to improve and in the aspect the future looks promising and downright spectacular. I am ever thankful to my clients who continue to challenge me to practice my profession to the best that I am capable. I implore my fellow general practitioners to remember the principles that have made this a great profession and ask them to be diligent of the potential harmful changes that may challenge our profession now and in the future. I most of all would like to thank God that I have been given this opportunity to do what I truly love. So until I write again, I wish you and your animal family members good health and good life.
Dr. Z
All Care Animal Hospital
504 S US Highway 27
Minneola, FL 34715
(352) 394-7444 |
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