Wednesday, July 4, 2012

Change Is In The Air

Resistance is futile

That's right. I said it. Resistance to change is in the end a futile endeavor. Life in general is an ever flowing stream of energy, constantly CHANGING and adapting as it goes. Look around you. The vegetation is constantly changing to adapt to soil and weather conditions. Animals must find ways to survive in their habitats or migrate to areas where they can flourish. People are no different. Unfortunately in a lot of cases humans have forced the changes on their fellow Earth inhabitants and not always for the good. 

Today, I don't want to discuss the harm that man has done to the planet. Instead, I'd like to focus on those little every day changes one must make in their lives to make things move forward. Be it with your health, family or career there are many ways you can better yourself and achieve true happiness and balance if you open your eyes and your mind to alternate paths. Today's post will lean more toward changes in the field I work in now, medicine.

If It Ain't Broke, Why Fix it?

Just because you've done something one way for a while or in some cases years, doesn't mean it's still the best way to do things. In my profession as a veterinarian for example, medicine is constantly evolving. There are new surgical techniques developed, stronger medications, vaccinations, new breeds of animals, new discoveries of how individual species react to medications, develop illnesses and recover from them. There's a LOT of information being thrown at us all the time not to mention what gets posted on the Internet. There's so much misinformation out there about the health of animals and it really complicates matters. In some cases it downright does more harm than good.

There was a time, not so long ago (sorry, I've got Bon Jovi songs running through my head right now) when it was unheard of to send pain medications home with pets recovering from spays, neuters or even major surgeries like fracture repairs. Even today there're veterinarians who don't make it a routine part of their treatment plans to control the pain in their patients. Why? They never did it before, why should they do it now? Their patients recovered just fine without those new fangled expensive drugs.

Really? Just because a patient remains quiet and huddled in the corner of the cage or it's little bed at home doesn't mean it's just sleeping off the anesthetics. It's not moving because it HURTS to do so. Come on people! It's not just a spay. It's a complete ovarian hysterectomy! When humans have this procedure done they are knocked completely out and are full of pain killers for at least a week after they go home from the hospital. They are not up and running the next day. Sorry charlie!  So why should our four legged patients not get the same kind of medical care and pain relief?

Ignorance is Bliss

It's these archaic ideas about medicine that keep animal owners ignorant. Yes that's right. I said IGNORANT and willing to believe the bullshit rather than what's now considered the standard of care for their pets simply because it's less expensive to do it that way. They've had (insert type of pet here) all of their lives, they know better than some young smart ass doctor who is only out to take their money. Really? If I was out to take your money, I would've chosen another career all together. Just last night I had a client yell at me on the phone because I wouldn't fill a particular prescription for her cat. She wanted something that needed an exam first before we'd consider sending it home with her, and yet she kept pressing me to say yes. She didn't call us until the last hour we were open for business. This happened to be a favorite trick of hers in order to get other medication filled for her pet. Unfortunately, we have relented in the past because the medication was something we KNEW her pet needed already and as always she would promise to be in for an exam within the next month.

Here we were two months later and she wanted to pick up fluids. We had never dispensed them for her pet before and we have no way of knowing if it really needed them or not. She kept saying her pet was fine, just a little dehydrated and could use some fluids. She wanted me to give the okay for her to pick some up. I refused. We hadn't seen her elderly pet in over six months and it's on some potent medications. We needed to do a full exam to be sure the pet was indeed dehydrated or sick from something else. That's when the conversation got nasty. After I told her once again no, she then said "so you're just going to let my cat die because I can't afford to see an emergency vet." 

She hung up on me. She will keep herself in denial until her cat goes downhill to the point where there is no turning back. Sometimes you just can't help people who refuse to listen.

In the late 1970's parvovirus hit with a vengeance.  At that time, no dogs had immunity to it and it spread like wildfire. Veterinarians were inundated with these poor puppies dropping like flies and no one knew what the hell was killing them. Now we have vaccinations that can keep these puppies healthy as well as certain protocols to follow until their vaccine series is complete. Unfortunately, even now we still lose hundreds of puppies every year because people don't vaccinate their dogs and take them everywhere, exposing them and the environment to this deadly virus.  

Why aren't they vaccinating? Well some stay away from it because they read on the Internet vaccines are the killer here, not the virus. There are breeders who perpetuate the myth that "vets are only out to get your money. Don't listen to them about the vaccines." Because of that tidbit there have been outbreaks of canine distemper all over the country too. Yeah, vets are the bad guys until your animal gets that horrible disease that could have been prevented all along. Makes me so sad and yeah really looking forward to the day I retire. One can only take so much smacking your head against the wall!

Listen to your heart and your audience

So who is actually driving all the changes in veterinary medicine? Believe it or not, the pet owners. Our clients want to have their fur babies live longer, play harder, and enjoy life with the whole family. In order to do that, veterinarians have to listen to what they want. Chemotherapy, Western and Chinese medicine, nutritional food choices at affordable prices, insurance to help offset the medical costs, emergency care, and when the time comes grief counseling. They want prompt service and hate to wait for it. They understand having to wait in the emergency room, but having to wait two hours to have a routine health visit is becoming unacceptable. On the other hand, they want to know they can drop in to see someone during business hours if they have an unexpected emergency/illness.

For years our hospital tried to cater to this by seeing walk ins. This in itself was a great idea at first. Unfortunately it's now turned into something that's spun out of control. Having only a couple doctors seeing appointments and one or two others seeing the walk ins creates a mess. Clients can't always get to see the doctor they want to see. They want an actual appointment and don't want to have to wait in the first come first serve line. Top that off with emergencies coming in the middle of things and the backlog gets even larger. 

Our staff had been trained to tell people to feel free to drop in all day until such and such time. Unfortunately, that has lead to huge backups at times, specifically around 5-6pm. Some of those drop in clients call early in the day to get an appointment but are told none were available. Instead of dropping in earlier in the day, they come after dinner, or after work. Now since we close at 9pm, having 10 or more walk ins waiting to be scene by ONE doctor gets a bit much.  

I've worked in hospitals that were only walk in and they flourished. I've worked in clinics where it was only appointments, but we squeezed in anyone who needed to be seen. Basically an appointment secured your place in line. Those practices thrived too. Now with this one, it's time to change. Our clients are really missing the ability to have those appointments. So to cater to this, we've started an all appointment schedule with hold slots to accommodate to same day appointments/emergencies and walk ins.

Sounds good right? Not for some people. The resistance here is not from our clients, but from some of the staff. They've only known one way of doing things and they just don't want to learn a new method. They want to keep the status quo. Why? Variety of different reasons for this one.  Here are a few excuses...I mean concerns they have. 

We'll be turning people away who want to drop in.

No we won't. These folks usually call ahead to find out the wait time. If we can give them a same day appointment, they will be more than happy to take it. The phones ring off the hook with these wait time requests. Why not give them what they've been asking for all along?

We need a designated drop in doctor to help keep the appointments running on time. 

No we don't. The drop in doctor has become the do all and be all. Not only do they have to take care of the patients who were dropped off in the morning for grooming and boarding, they have to take the random phone calls from clients, pick up the patients for the appointment doctors who are running behind, take the appointments who show up late and still cover anyone who drops in on their own and any emergencies. This has created some tension at times when once again the appointment doctor declares the client who was only 10 minutes late now has to be seen by the drop in doctor. With so much to accomplish during the day, it leaves very little time to actually spend in the room with the clients. Not a good thing. Clients want more of our time, not less.

It's going to lead to confusion as to who's going to see the emergency or drop in that is waiting to be seen.

This is a valid point now in the early stages. Once we get our flow going and used to the new schedule, that confusion will fall away. The doctors who've always jumped in and did extra patients will continue to do that. Those who hang back and stay at a slow pace will continue to do that. The difference now is the slower doctor can't shove off their appointments onto someone else while they take an hour or two with one. We are a fast paced hospital and always have been. If you're not a fast paced doctor, tech or receptionist, this hospital is not for you. Plain and simple.

It's just not going to work. Our long time clients will hate it and the new clients won't come in if they can't just drop in whenever.

This is just stupid. Sorry to be so harsh, but COME ON! It's for our long term clients we are doing this. They're the ones who want the appointments and who have been the loudest voicing their displeasure. Why are we catering to clients we don't even have yet? How about we keep the ones we have happy and they in turn will spread the word far and wide about us to their friends and family.

We're going to lose business to competitors.

Not one bit. Those clinics will still be turning their clients away while we make them same day or next day appointments. It's a win/win situation for us and for our clients both old and new. In fact, we will continue to get new clients because we can offer them the same service with scheduled appointments and squeezing them in if necessary.

Finding peace through the chaos

I truly believe this is the way our practice needs to go in order to achieve the goals of our hospital and in the service community. I feel this is the best way to fulfill our mission statement.

Where your pet's health is our top priority and excellent service is our goal.

By listening to our clients and offering them what they've wanted all along, how can we go wrong?

I'm looking at the final years of my career as a full time veterinarian. I want to be able to leave knowing I've done everything I can to keep my patients healthy and still say I'e enjoyed my time as their doctor.  Wouldn't you want to say the same?

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