The words you use and the tone you have can make all the difference! Sometimes a veterinarian has an unfortunate style of communication, and regularly pisses off their coworkers. They use an unfortunate choice of words, or an aggressive tone, and in return receive a cranky or negative response.  Unfortunately, these doctors simply have no self-awareness of the effect their communication has on others; as a result, they feel angry, unjustly denied, and completely in the right. It all boils down to poor communication skills.

Many of these doctors develop mostly personal good will (more on this in a later blog;) they encourage their clients to regularly call the vet’s cell phone rather than contacting the veterinary practice office. They answer calls while on vacation, form a diagnosis and treatment plan over the phone, and then call a veterinarian at the practice back home to say something like: “Very Important Client called because Crazy Lunatic has a laceration and is lame. I need you to go do a regional limb perfusion with Drug X while standing on your head over at Far Faraway Farm. You need to get there right away.” This is always said in an aggressive tone, as though they expected to be challenged. Invariably, the selected party’s hackles rise. Their immediate perception is “He must think I don’t have any of my own work to do. He must think I’m incompetent to examine, diagnose, and make a treatment plan. He must think his clients are more important than mine. He must think HE is more important than me.” Then the gnashing of the teeth, the contemplation of a two hour drive and the difficult job ahead combine to make the recipient of the message HATE their job, their life and the messenger. Sometimes heated words are exchanged. Sometimes the recipient refuses and then feels terribly guilty about it. Generally both parties end the conversation angry, dissatisfied, and misunderstood.

Imagine if instead, this vacationing veterinarian (although still addicted to his personal good will) called his colleague to say “Hey. I’m really sorry to bother you. I need your help. I’m on vacation, but Very Important Client called me, and has a very lame horse. Unfortunately it’s that horrible Crazy Lunatic. Any chance you could take care of it?” Then PAUSED.  Allowed the recipient veterinarian to receive the gift of being allowed to help someone. Allowed them to give the gift of generosity!  Allowed that veterinarian to ask appropriate professional questions about the history. This might naturally lead into “So if xyz is going on, what treatment are you most comfortable with? What will Very Important Client be expecting?” Simply by changing the tone and words used in the conversation, and allowing the recipient veterinarian to be treated like their opinion matters, that they are an equal, and they have a CHOICE, the feelings created are entirely different. The recipient of the extra burden may be sighing, but they won’t be gnashing their teeth or cursing or throwing things. They probably also won’t be hating their life, veterinary medicine, or their colleague.

In every interaction you have, you have the chance to give others the gift of an opportunity to be generous. Doing selfless deeds makes a person feel good. The next time you are ready to bark out an order, consider asking for help. The next time you are ready to give your recommendations to a client like rules handed down by God to be followed to the letter, engage your client in a conversation about best options. The next time your kids are fighting over the last piece of cake, ask them for their help in deciding the fairest way to divide it. Everybody will feel better.

The next phase is trickier. The veterinarian, now with five years’ experience or so, becomes comfortable in his or her abilities, so comfortable he or she begins to become judgmental of other veterinarians. It is almost certainly an unconscious ego building activity; after all, to think you can play God with your patient’s lives is a big responsibility and requires a very strong ego. There is a dark side to the ego; being humble fades away and a swagger may develop. There is self-satisfaction, and it is sometimes hard to figure out if it is appropriate pride or more like the Emperor’s clothes. Eventually something bad happens, even though sometimes it takes many years. Sometimes only the veterinarian knows they made a mistake or an omission, or sometimes it is a big stinking steaming pile of a mistake for all to see.  These ego corrections are inevitable, and they help to forge compassion and understanding of the human condition.

As veterinarians mature over decades, they often become self-effacing, humble and quick to give help when asked by their colleagues. Tempered by the fire of experience, they know there are many ways to treat and heal. They have seen their share of wrecks and their share of glorious triumphs against all odds. As the years go by, some become irascible, and resist all new methods and techniques. They are often referred to as “dinosaurs” by their younger colleagues. Others embark on lifetime learning, and become incredibly skilled practitioners with an amazing depth of knowledge. They become revered in the veterinary community when they share their experience by mentoring others.

When a veterinarian’s career is coming to a close, it is important to spend several years transferring client allegiance to younger doctors to make sure clients will be satisfied and patients well cared for.  This requires the difficult recognition that others can fill your shoes and provide excellent outcomes; that you are, in fact, replaceable. Worse, you actively need to facilitate your replacement. This is not to say that people won’t miss you, but the world will not stop turning if you are no longer practicing. It can be a hard reality to face.

The flip side is that often the intense life of a veterinarian has prevented the development of other passions like travelling, writing poetry or playing in a rock band. Veterinary medicine has a way of absorbing all of a doctor’s time, energy and passion. So when you retire, let it rip, and have a great time!

I see this occurring in my clients too. Recently, as I begin to need glasses and my knees aren’t what they used to be, some of the little kids that I watched growing up now are young adults, and they are more comfortable with a veterinarian that is more their age. At first it really hurt my feelings, so I examined the situation more closely. I even asked my peer aged friend to inquire of one of the twenty-something horse owners that she knew. Had I done something wrong? Had I offended them in some way? The answer I got was interesting. The young woman replied that she liked to see Dr. A better because she was “like a friend”, and liked the same music and clubs, and they could “relate”. This made me feel better; at least I hadn’t been a jerk without knowing it. The rest of the feedback “She’s more like my mother’s age” prompted me to wrinkle my brow. I did some reflection. Would I prefer someone my mother’s age or someone more like a peer, if I were a client? Definitely the peer said the little voice in my head. I started paying attention, and realized that many of my most loyal clients were my peers: we could joke about our aching knees, our hot flashes, our 401K accounts. We adored our horses, and didn’t care much about showing anymore. I understood their concerns, not just about their horses, but about their lives. When these clients have a visit from one of our younger veterinarians, I generally get a call; the client wants my opinion on the handling of the case because we “speak the same language”. These moments give me an opportunity to support my less experienced colleagues, and start the process of forging new bonds for my clients with the younger practitioners in anticipation of my retirement.

Back to sitting at my desk, and feeling underutilized…it is hard not to feel a little sad as you watch young veterinarians animatedly debating a new surgical technique you have little knowledge of, and you realize that you were them just a few years (well okay, decades) ago. But that sadness quickly turns to pride when you realize how proud you are to be part of a profession that is constantly growing and changing to provide the very best care to horses and their people. Veterinarians rock!

My dear sweet little Beagle, Emily, has been coughing a little while she is sleeping for the last month. She’s also been a little less perky, and has lost a little weight. But she still plays chase games with our other Beagle, Dill Pickle, and seems mostly like herself. But after a month of the cough not resolving, I finally asked the interns in my equine hospital to take some radiographs and run some blood work; after 25 years of equine practice, I’m WAY far away from the small animal piece. But even my eyes could see the two golf ball sized masses in her doggie chest. Suddenly I have become a client. I need to trust someone to aspirate her mass to determine the type (probably a primary adenocarcinoma) and then perform a thoracotomy and remove one of her lung lobes.

If any of you have ever injured your ribs, you know how painful that is. I’m concerned about the technical expertise of the surgeon (“This is a rare tumor. How many of these surgeries have you done?”),  but more concerned that my furry friend has adequate pain relief, a warm dry blanket to lie on, someone petting her while she is hospitalized, and calling her by name with affection. I want, above all, to know that she will be CARED for.

Clients have no way of telling if a veterinarian is technically competent. They can ask for word of mouth recommendations, and they can read certificates and diplomas on the wall, but who hasn’t got those? It is no wonder that they frequently have fear or anxiety when they arrive at a referral hospital!

What really matters is how the facility makes them feel. If every person that they encounter seems to genuinely care about their animal, they gain confidence that the work done there will be done with precision and care. If every part of the hospital is clean and organized, they feel confidence that extra gauze sponges won’t be left inside the patient. If the stalls or cages are pristinely clean, with deep bedding or comfy blankets, they begin to relax and make jokes about how their horse or dog is staying at the Ritz Carleton!

When I decide who is going to care for Emily, my decision will be made by these talismans of caring: the receptionist who calls her by name; the technician who pets her and talks soothingly; the doctor who addresses questions about pain management and immediate post-surgical care without needing to be asked; the facility that is calm, clean and organized. Caring that is demonstrated in every step of the process. This is what matters!

The message to take away: Caring matters. The entire veterinary team weaves the warm blanket of caring that enfolds the client and their animal. Make sure your team is doing this important work. And when you make referrals, make sure caring is alive and well at the facility where you are sending your clients.

Emily had multiple masses in her liver as well as her right dorsal lung lobe. I elected to do no treatment but simply give her lots of love. She is thriving a year later, enjoying her life, and showing few signs that she has cancer.   September 2014

On Christmas Eve 2014, dear Emily died surrounded by her human family and her Beagle companion. Though she couldn’t run in circles for very long, and sometimes woke up coughing, she enjoyed her life to the very end. She was an inspiration, and I miss her very much.  January 2015