Because You Are Not a Doctor

As an adult, I have come to accept I do some things very poorly. Here are some of them: negotiate contracts, invest money, repair electrical outlets, replace broken pipes. Consequently, I do not consider myself an attorney, a financial advisor, an electrician or a plumber.

Even as a veterinarian, there are certain specialties at which I am less proficient, certainly at all of them less so than a specialist. They include: orthopedic surgery, ophthalmology, neurology, dermatology.  (Honestly, that list goes on a long while, and there are many days I curse Alaska's distance from veterinary universities and specialty practices, though we are fortunate to be welcoming new veterinary specialists each year.)

Furthermore, as a medical doctor, I have quite a bit of knowledge -- both book- and practical- -- about things like antibiotics, laboratory tests, radiographs (xrays), anesthesia, surgery, .... But I confess I am not always aware of the nuanced differences between human medicine and veterinary medicine. So, when I am sick, I go see a doctor. A human doctor. And I do not tell her what tests to run or what drugs to prescribe for me, other than to comment if I have a personal experience to share, such as stomach-upset with cephalexin antibiotic, or headaches the last time I took Claritin.

So it never ceases to amaze me when laypeople come into my practice with their pets and tell me what they found on the internet, what I should do about their pet's problem, and why my own plan is wrong. 

????

In just the past week, I've experienced the following encounters with clients:

-- A concerned owner who "looked it up on the Internet" and gave his dog a massive overdose of human aspirin, which did help with the pain but also caused significant stomach irritation and possibly stomach ulcers, as well;

-- A guy bringing his Malamute in for his annual exam and vaccinations, and requested I empty the dog's anal glands because "malamutes & huskies need to have it done once a year." (They don't.)

-- A nurse from a remote bush community (only accessible by plane) who didn't want to fly her dog in to Anchorage, so she wanted me to diagnose her pet over the phone and give her a treatment plan she could administer herself.
[Don't get me started on nurses and human doctors, who are their own version of incorrigible, and so I am saving their dressing-down for their own later blog post.]

Alas, I have been in this game too long to let these remarks pass without a comment of my own, so you can imagine the looks on the clients' faces when I say -- as I now do, nearly every single time -- "Well, you know, the Internet knows everything!" (If they're interested, I then tell them how, when I was working at a wildlife park, I found a blog post saying you should feel wolves coffee grounds to help strengthen their bones. [Not true. And toxic.])

The funny thing is, I mostly sympathize. Some years ago, my doctor told me I had a minor skin ailment, and pretty much the first thing I did when I got home was look it up on WebMD. I figured WebMD was a good choice, since it's the one a physician used one day right in front of me while he was treating me for a cat bite wound to my finger. No lie.

But -- BUT!!! -- as a medical doctor, I understand what is implied but not specifically spelled out in these online articles: they are written for the masses. Which is to say, not every variation and permutation of each disease is going to be represented in these summaries. And the list of potential side effects rarely has even a percentage behind it, so it looks (online) like every time I take a Benadryl, I am almost certainly going to die from cerebral hemorrhage.

Medicine is an art form. It takes skill and knowledge and experience and research and comprehensive patient assessment to determine what the best choices are for that patient. And sometimes the therapy is adjusted, if ineffective, and that data is also valuable in determining the best plan for ongoing treatment. For example, if a pain medication administered to your dog for its legs trembling, and the medication does nothing for the trembling, then it's probably not pain-related but something else. Or if the antibiotic prescribed for an infection does not help the symptoms, perhaps the infection is antibiotic-resistant. Or, it's not an infection at all. 

I cannot begin to tell you how many dogs I've treated over the years for yeast infection in the ears, which have been ineffectively treated by the owners (sometimes for months, to the great discomfort of the dog, before the owner will seek professional care) for ear mites, which are common in cats but rare in dogs. And, as errors in judgment go, this one is pretty mild, usually with no longterm consequences. Not all pets are so lucky, like the cat who was given Tylenol. Or the dog who was given Advil or, worse, Aleve. 

Here is the thing you must accept: You are not a doctor. And watching a YouTube video on how to perform a splenectomy does not qualify you to perform one, any more than watching a video on how to work a paint-sprayer recently kept me from completely splattering my yard, my clothes, my hands, my hair with paint in spite of watching that video at least seven times before I turned the damn thing on. And paint sprayers don't hemorrhage to death (though this one certainly gave it a good effort)

Any idiot can spay a dog or cat. As long as it goes well. -- But what happens if it doesn't go well? Or if your dog or cat has an abnormality or variation in anatomy or condition? Or if you drop one of the blood vessels before it's tied off? -- Gee.....

The same is true for medical plans. You may not understand why I choose the antibiotic I choose, but you don't have to. This is my job. This is what I'm trained to do and have been doing for twenty years. And it's what you pay me for. Relax. Enjoy letting someone else take care of your loved one for a minute. You don't have to research every potential side effect of every medication -- it'll just make you crazy if you do. If you're having a problem with the medication or your pet isn't getting better, then of course I want to hear from you. But otherwise, trust a little.  And if you don't trust, then find another doctor. And if you don't trust any doctors? You should maybe see a therapist.

In these days of Internet access, everyone is suddenly an expert. I do actually have clients who believe that they know as much as I do about veterinary medicine. Trust me on this one: you don't. I'll be the first person to admit I don't know everything, but I almost certainly know a hell of a lot more than you do. I'm willing to work with you to help your pet, but it really irks me when a client has the attitude that we are on some sort of level playing field just because they looked a couple things up on Google. And when I tell you you're mistaken, I do it graciously, so try not to be too offended. Or a dick. Try not to be a dick. 

I'm old enough to remember and miss the days of Marcus Welby, when the patient would just say, "Yes, Doctor." Hell, half my clients don't even call me doctor, jumping instantly to the familiarity of using my first name. That bothers me, too -- I admit it. But it bothers me far less than people who play doctor with their poor pets' lives and then get upset when I am not interested in detailing each step in the path I plan to take to try to correct the problem their behavior worsened. 

I'm not telling you not to educate yourself. I'm just asking you to consider, just for a moment, that fifteen minutes spent on the Interweb just might be less educational than six to ten years in a medical training program.

I'll say it again: You are not a doctor. I am. So why don't you just let me do my job? And let's leave Dr Google out of it.