Q: "My veterinarian is retiring soon and I don't know where I'll find another who cares about me and my dog as much as he has all these years. Every vet I talk to seems to be a specialist and only deal with certain diseases or certain species. I want a good, old-fashioned vet who can do it all!"
A: Well, luckily, there are still many, many veterinarians in smaller private practices who "do it all" and truly care about the people and pets they serve. But, you do have to do your homework rather than just going to the clinic that is nearest to your house.
Just like human health care, veterinary medicine is moving toward board certified specialties, as well as insurance-driven diagnostics and procedures. While these two developments haven't yet had wide-spread impact on the overall 'culture of care' that characterizes veterinary medicine, many are worried that it may in the not-so-distant future.
I was excited to see this topic addressed in Ellen Goodman's column "Refocus on care in health care" this weekend. "I don't think we're talking enough about the 'care' in health care," Goodman wrote. Discussing the dearth of primary care physicians in favor of specialists, Goodman went on to describe a U.S. health care system that "rewards procedures over primary care" and the "use of equipment and technology over the medicine that is practiced with eyes, ears, and mind."
Goodman elaborated on the current business model of modern medicine citing a thought piece written by Drs. Jerome Groopman and Pamela Hartzband in the New England Journal of Medicine. Noting that our current system of assigning a monetary value to every aspect of a doctor's time and effort may hinder the role doctors play in both the marketplace and our communities (in the latter, the relationship should be that of extended family where "doctors are expected to help when help is needed, regardless of money"), Goodman quotes Groopman saying, "The really hard conversation about health care is not going on. The hard conversation involves what we value as a society and what translates into the kind of 'care' we all want."
According to Goodman, this brand of 'care' includes a doctor who can diagnose, manage, coordinate, and comfort.
I know this is the type of physician and veterianarian I want. In fact, I insist upon it. I have switched doctors and veterinarians due simply to poor communication and the feeling that they just weren't "there" for my pets or family. I would go so far to say that how a doctor demonstrates his or her willingness to 'care' is of the utmost importance to me. And research bears that out. In one study, respondents said their doctor's ability to 'care' was more important to them than the ability to 'cure.'
What's your priority? If all docs and vets were equal in their medical skills, what else would you look for and what traits would help you select and stay with a care provider? (photo from istockphoto.com)
--Laurel
Hi Laurel,
I was fascinated to read Ellen Goodman's column. I agree with you in that veterinary medicine has reached a level of technical sophistication that now rivals human medicine. It's interesting to see that with more and more specialists...the personal, familial care is getting sacrificed.
For me, care is everything for both myself and my loved ones (human and animal). While my Oncologist cannot guarantee that my cancer is gone forever, his care and concern reassures me that he will do everything in his power to help me for as long as needed. That's what I draw comfort and support from.
I think that for certain specialists, their communication skills are even more important than for others (such as an Oncologist in veterinary or human medicine). After all, their asking their patients and families to endure treatments that will NOT feel good and may make even make them sicker than before. If the patient can't trust the doctor completely, the whole treatment process is compromised.
Posted by: Dana Durrance | April 09, 2009 at 08:22 AM