Mind Over Miller: The stethoscope: Not just a doc prop

November 1, 2017
Robert M. Miller, DVM
Robert M. Miller, DVM

Dr. Miller is an author and a cartoonist, speaker, and Veterinary Medicine Practitioner Advisory Board member from Thousand Oaks, Calif. His thoughts in "Mind Over Miller" are drawn from 32 years as a mixed-animal practitioner.

A stethoscope at the ready is a sign of progress in veterinary medicine, Dr. Miller says-it reflects an ability to differentiate normal from abnormal.

Getting an ear for the internal. (Shutterstock)Before I entered this profession, and during the decade after my graduation, most veterinarians did not visibly wear a stethoscope. The small animal practitioners kept them in examining room drawers. The large animal practitioners kept them in their vehicles' dashboard glove boxes. The stethoscopes were removed from concealment only when needed for thoracic or abdominal examination.

Why I always had one at the ready

When I began practice myself, I realized that recognizing the abnormal requires a thorough knowledge of the normal, so I always carried my stethoscope. On large animal calls, it was in my pocket. In the small animal office, it was in my white examining gown pocket. I tried to use it on every patient, even if just for a routine vaccination.

Today when I visit a veterinary practice or when I watch the increasingly popular and varied TV programs featuring real veterinary practices, I see that the doctors invariably have their stethoscopes draped around their necks. This is good. It encourages more frequent use and more familiarization with the variations that occur within normalcy.

It's the same as understanding an animal's gait. You must know the variations in normal gaits to recognize the slightly abnormal. For example, I recall an experience wherein four colleagues, all in separate practices, were asked simultaneously to evaluate the gait of an extremely valuable stallion. Two of us recognized a very slight right hind lameness. The other two (significantly younger and probably having better eyesight) could not see the lameness.

Milking a moment of client confusion

Always wearing my stethoscope inevitably led to some amusing incidents. For example, when a 13-year-old girl fainted in the exam room while watching an intravenous injection and hit her head on the floor, I rushed her to a local physician. (We did not yet have a hospital in town.)

The physician said to leave her in his office until he felt it was safe to send her home. I gratefully rushed out of his exam room, and as I passed the reception desk with my white gown and my stethoscope fluttering, the receptionist was admitting a patient. She said, “Mrs. McCarthy, do you want to see Dr. Larsen or Dr. Brisbane?”

Mrs. McCarthy replied, “It doesn't matter.”

Then, as I passed, she added, “Except him-he's a vet! He treats our horses and dogs! What are you doing here, Dr. Miller?”

“I'm only here part-time,” I explained as I rushed past.

Robert M. Miller, DVM, is an author and a cartoonist and speaker from Thousand Oaks, California. His thoughts in "Mind Over Miller" are drawn from 32 years as a mixed-animal practitioner. Visit his website at www.robertmmiller.com.