Remember why you're a veterinarian
The graceful shape of a cat's face. The watchful eye of a dog. The smile of a grateful client. These are the faces of veterinary care. They keep us going and can help us succeed in practice, conquer our mountains, and be the best veterinarians we can be.
One day not so long ago, I experienced an interesting phenomenon. Three different people—three of the dozens of faces I see every day—came in with their pets for medical treatment, and each one told me how much they were prepared to spend. One client could spend $100. Another was limited to $200, and the third client said $300 was the maximum she could spend. No one had told these clients how to negotiate with a veterinarian—although some people advise our clients to do this.
Knowing their spending parameters, I gave the same recommendations I would have anyway to the $100 and $200 clients, but with deferred payment options. I would love to have diagnosed the third dog with a $300-or-less disease, but it wasn't the case. Here, like a pediatrician would do with a child, I did with the pet: I advocated for the necessary care. And after hearing the passion in my voice when I told her why I felt strongly that we had to treat her pet with this course of action, she asked how much it would be. It was $480. She didn't say yes, she said YES.
Even stars want to be you
I've always practiced according to this principle: "Tell people what they need—but only what they need." As veterinarians, we can still do everything we need to, but maybe not all at once. If a client's dog has flea allergy dermatitis and needs to be on a strong parasite control program, perhaps he can get caught up on vaccines later.
This may not be how you imagined practice would be. In fact, you may feel lost. If so, perhaps I have something to offer.
Facing your mountain
How many times have you taken a false route on the climb? Felt yourself slip and been caught by someone or something? Gone from clear days to blizzards or experienced months that seemed straight up followed by a sharp downhill? Did you ever do the crazy one-arm hold on a precipice—building a hospital, buying equipment, firing staff—when you didn't feel like you could hold on and didn't know what was just up and over the next incline? Well, you're not alone.
In veterinary medicine, none of us have exactly the same mountain to climb. Our challenges and our triumphs are all different. My mountain is not your mountain.
In fact, some of you might think of your mountain more like a tree—or a stepladder. Maybe yours looks more like a circle because you don't seem to be getting anywhere. Maybe it looks like the stock market: up, then down, then up. (Then down.)
Where are you? Are you in the foothills? Are you near the top? Are you on the lowest branches of the tree? Or are you way out on a limb? Are you climbing the mountain or sliding down the other side?
There's no right or wrong place to be on this journey. But the economy has presented us with a new mountain to climb. Some people think this frugal time will pass by eventually. I think the new fidelity might be here to stay. The "new normal" is shorthand for the reality of hard times.
As we climb this mountain, all of us will have to work harder. "Compliance" will no longer be the right word to describe our relationship with clients. Clients won't "comply"; they'll follow the plan we work out together with them in the exam room.
In the old days, we gave an estimate or quote, explained it, and the client pulled out a platinum card. What a different thing it is when he or she begins by telling us, "This is how much I have to spend." Maybe this new frugality won't last forever—but for many doctors, it's here now. Let's get back to basics. Let's remember why we do what we do.
The power of puppy breath
Close your eyes and take a moment to remember what the air smelled like the last time you stood on a mountain: crisp, clean, light as a first snow, unfettered, uncluttered, free. You might actually call that smell triumphant.
That smell must be part of the allure of mountain climbing—to go where few have left a footprint, to see as far as the eye can see, to smell the air at the peak of a continent, and to know that few other people have taken a breath there.
Now I want you to get down on your knees—figuratively—on the floor of the high temple of veterinary medicine: the exam room. Kneel down in that exam room, take a breath, and remember the smell of sweet-and-sour puppy breath. (That's the best way I know to describe it.) Or, if you prefer, imagine that earthy smell you inhale when you burrow your nose into the fur of an 8-week-old kitten. Or think about that grass-and-sweat smell of a horse. Or better yet, a horse's odor mixed with wood shavings—I love that.
In the hustle of a busy day, trying to balance appointments, surgery, and medical records on the fly, with squabbles to resolve and the fear of leaner times in the air, it's as easy to forget the smell of puppy breath, kitten fur, and horse sweat as it is to forget the smell of a mountaintop.
I'd like to share with you one important secret I've learned since I put the white smock back on and laid the stethoscope around my neck and went back to the high temple. The secret is this: The way to the mountaintop is to get down on your knees and smell puppy breath.
The perfect dog
To encourage you in your climb, I offer you this simple story. It has no dramatic finish, no heroic rescue, no sleuthing CSI-type medical discovery. As fulfilling as those things are—and our professional lives are full of them—they are not the way to the mountaintop.
The woman with the perfect dog was in the parking lot of North Idaho Animal Hospital in Sandpoint, Idaho, where I practice as an associate veterinarian. It was a few months ago when I was walking into the clinic from the parking lot.
I stopped and petted her dog, a beautiful golden retriever. "What a beautiful dog you have," I said. "She has beautiful eyes, and I can tell she loves you." I had no idea that that dog would be my first appointment of the day.
The owner's name was Cathy, and the golden retriever, Lily, was 7 years old. She had a mass on her spine just in front of the base of her tail.
When I met Cathy in the exam room, I said, "I bet you were worried sick this was a deadly cancer." She simply nodded her head in agreement. I could see the fear in her eyes.
I explained that I was going to look at the mass, but not until I'd done a full exam from the tip of the nose to the tip of the tail. I didn't want to overlook anything else. With no abnormal findings on the physical exam, I zeroed in on the mass.
With my technician helping, I showed Cathy how to tell whether the growth was a cause for concern. Cathy put on her reading glasses and got down on the floor with us as I checked off the boxes: regular margin, not ulcerated, freely movable, no adjacent lymph node involvement. I also told her to examine the mass herself. She ran her hands over and around it.
I told Cathy it was most likely a lipoma or a fatty tumor, then turned to Lily and said, "You've got a wonderful mom. Looks like you two are going to be together for a long, long time." Cathy bonded with me right there in that instant.
Pet owners want to learn. Pet owners want you to express empathy, to take away the worry. They want more than anything else to know how much you care—before they care how much you know. Cathy was happy that I liked her dog; I complimented her on the care she was giving Lily. I told her she was doing a perfect job.
I was doing what no one on the Internet can do and what too many veterinarians don't do. Those veterinarians are worried about difficult times, they're distracted, and they're disengaged. They're not where I was—down on the floor of the high temple smelling dog breath. They don't take the time to acknowledge how much people love their pets and tell people what a great job they're doing with their care. I perked up for every client I saw after Cathy. I stepped up to the exam room door, raised my head, dropped my shoulders, and said to myself, "This is the most important pet and client I will see today."
This is what I was born and raised to do. I suture lacerations, I alleviate pain, and I do it all for the animals and their people. I'm working for smiling faces and climbing my mountain—and enjoying the fresh air and puppy breath—for another day.
Dr. Marty Becker is a Veterinary Economics Editorial Advisory Board member, writer, speaker, and resident veterinarian for Good Morning America.
*This article was adapted from an evening session sponsored by Elanco at CVC San Diego in 2010. Missed it? Dr. Becker will be presenting at CVC Washington, D.C., in May.