We need to hospitalize more often


Ask yourself if you're truly confident the case will proceed well under home care.

Hospitalization is a hallmark of good veterinary care. It gives a doctor more time to examine a pet, review the history, record progress, and interpret test results. This in turn increases diagnostic accuracy, leads to more appropriate treatment, and produces greater profit for the practice. Unfortunately, many practitioners aren't hospitalizing patients often enough.

Ronald Stone, DVM

Cases that call for hospital care generally fall into three categories: contagious diseases; conditions for which the client lacks the ability to provide care at home; and conditions the client doesn't want to deal with. Let's look in detail at the benefits of hospitalization:

1 More time. How many times has a client come in for a routine vaccination and mentioned another problem—when you have a waiting room full of other clients and you're already behind schedule? Hospitalization gives you the chance to examine the pet more thoroughly.

2 Client satisfaction. If you send a patient home with the instruction to "come back if it doesn't get better," that client may very well seek more attentive care elsewhere. Don't confuse failure of a patient to return with a successful outcome or a satisfied owner.

3 Observation of treatment. Without observation, you can't confirm a diagnosis or judge treatment efficacy. While many patients respond to simple therapy, a significant percentage will continue to suffer from the entering complaint for several hours after onset of therapy. Many have underlying pathology or are misdiagnosed. Hospitalization can help you truly identify the problem.

4 An appropriate environment. You may need to remove the patient from an environment of external parasitism, poor sanitation, multiple animals, or aggressive children.

5 Less client stress. Some owners are physically or emotionally incapable of dealing with illness in their pets, and hospitalization takes the burden off them. It's unfair, for example, to expect an elderly couple to lavage a painful ear canal in a large dog or to expect a fastidious person to deal with diarrhea or vomiting. Many clients appreciate the peace of mind they get with hospitalization.

6 Greater profit. When you render more services, you generate more charges. However, I'm not suggesting you keep pets just for the fees. If the owner is just as capable of caring for the pet or if you're convinced the condition will resolve successfully, then there's no cause to keep the patient. What I am suggesting is that these situations are more rare than many veterinarians think.

Despite your sympathy for clients in tough financial situations, economic decisions are their responsibility. Restoring the pet's health is yours. Perceived financial constraints shouldn't influence your recommendations.

Before you send your next patient home, ask yourself if you're truly confident that the case will proceed to a satisfactory conclusion under home care. If you have any doubt, you're ethically obligated to hospitalize that patient or refer it to a facility that can provide the care it needs.

Dr. Ronald Stone handles small animals at Veterinary Trauma Center in Groveland, Fla., and is the author of a Western novel, Trail Hand. Send comments or questions to ve@advanstar.com

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