Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Human Doctor Clients: A Vet’s Worst Nightmare

January 21, 2010 / (6) comments


If there’s one class of client that gives us pause more than any other, it’s the human physician (and his or her spouse/partner). This may sound profoundly unfair (and is certainly not a hard and fast rule) yet many vets agree they are among the most difficult group of clients to handle. 

 

While I was in vet school, our professors drilled us on issues we should specifically explore should our animal patients have an on-the-side, at-home clinician making medical decisions for their pets in our stead. It was, even then, a well-recognized phenomenon.

 

Human doctors, feeling themselves capable of (at least) being able to treat simple diarrhea, limping, or basic infections, have a reputation for giving inappropriate drugs or administering human-oriented treatments based on off-the-mark diagnoses. Most of the time these actions are benign or merely wasteful (of time and medication), but on more than one occasion (in my personal experience) has led directly to an animal’s death. 

 

Tragic anecdote #1

A cat’s lethargy led her physician-owner to assume that his cat had a fever. Baby Tylenol twice daily for three days led to an irreversible blood disorder. She died less than 24 hours after her owner brought her in for her fever of unknown origin (her temperature was actually less than 96 degrees Fahrenheit).

 

Anecdote #2

An ill-informed physician gave his dog Advil for several days before realizing that, though his dog’s limp was better, neither her diarrhea nor her appetite had improved. His wife then called the hospital to see what could be done for the diarrhea. We advised her to bring the dog in for examination immediately — five days is a long time to have diarrhea. She demurred. ("After all it’s just a little loose stool. I think I’ll give her the bland diet you always suggest.")

 

After the dog collapsed during a short walk, the physician finally brought her in — DOA. After he blamed us for making her diarrhea worse because his wife had given the dog Pepto-Bismol — not our suggestion — he demanded a post-mortem. It wasn’t too hard to conclude she had died of blood loss subsequent to a gastric perforation. Her Advil-induced ulcer had finally eaten through the entire wall of her stomach, blood vessels and all. To the physician’s chagrin, his wife confessed on the spot to the at-home medication.

 

Anecdote #3

This one’s not so tragic but it led to the firing of a client. A client complained she shouldn’t have to pay for my veterinary services since those things I showed her on the X-ray of her dog’s bladder can’t possibly be stones. How did she figure this? Her boyfriend is a radiologist and he informed her that we had to be mistaken, and that she should refuse to pay her bill, because bladder stones are not visible on X-rays. (We called them bladder stones in vet school. Dump him now, sweetie. He’s a loser!)

 

Remember the maxim: A little knowledge is a dangerous thing, so beware. Dogs are not cats. And neither is human — though sometimes it might appear otherwise.

 

On the other side, veterinarians seem far less likely to diagnose and treat themselves. To be sure, some of us do (I've heard stories that would curl your toes), but I believe vets have a greater appreciation for the byzantine nature of interspecies differences. What constitutes a powerhouse drug for a cat might just as easily kill a dog. This is what we are taught from day one: never assume that any species shares a physiological trait with another.

 

Beyond the treatment and diagnosis thing, doctors (vets included) can be pains in the backside in almost any environment. Some of us display a deep sense of entitlement for having achieved a degree, status, and title that others haven’t. But let's agree on one thing: we should stick to the species we were assigned to when we received our licenses — unless we’re willing to go back to school and slog it out all over again.


Dr. Patty Khuly

 

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COMMENTS (6)
1
by Orli on 01/21/2010 04:24am

A dermatologist working in my father-in-law's office was once a veterinarian. I'm unaware of the circumstances that made her quit her vet job and go to human medical school (including the dermatological residency, which is apparently exactly as much fun as it sounds like) but I do know that she has a very healthy respect for doctors dealing in ALL species. Despite many of her human patients knowing that she used to be a vet, she refuses to diagnose their pet's ailments (including skin problems) and sends them all to their own, currently practicing vets.

Unlike said father-in-law's brother, who is a human radiologist. When his wife's cat fell gravely ill, and she brought it to the clinic where I was a technician at the time, he refused to allow any treatments at all to be done for the cat until and unless the vet called him and ran it by him, each and every time. This went on for close to 12 hours, with a phone call every 20 minutes to an hour that treatments were necessary (the cat was in oxygen, on several meds and fluids, and getting progressively worse) until finally the overnight doctor got in and put his foot down. His one and only call, made in a much more rational and calm manner than I would have used, basically told Dr. XRay that if he had a human who needed rads reviewed, he'd call him, but until then, either they trusted his judgment for the cat's treatment without second-guessing everything he did, or else they needed to take their cat elsewhere. Unfortunately, once the cat was stable they took her home, where she suffered several more days under the "care" of the human doctor before she died.

And yet, I never see a veterinarian trying to fix a human at home and expecting to be coddled for it because they went to medical school too, don'tcha know?

2
Human Doctor Clients
by Susan James on 01/21/2010 05:30pm

Excellent article! WIll pass this on to my doctor friends!

3
human doctors
by Maria Shanley on 01/24/2010 01:12pm

We had MD clients at both ends of the spectrum. The dreadful ones often refused to spend much money on "just a dog or cat", or brought dying animals in that were "fine yesterday". The wonderful ones brought in dinner for night staff on the weekends (wall to wall patients usually w/ barely time to write charts), helped find homes for rescue animals, came in and did pro bono specialty procedures (opthalmology, oral surgery, burn reconstruction), and in one case helped us run a code that happened while the MD in question was visiting his dog in ICU. Hope you get some good ones to balance the difficult!

4
by Outrider on 01/28/2010 06:57pm

Physician clients don't bother me at all. I actually enjoy my veterinarian clients. But nurses... sigh. Though not all of my nurse clients cause problems (some are excellent clients and lovely people besides), I estimate 8 or 9 of my 10 most frustrating clients are nurses. Really.

As for veterinarians treating themselves, well, I plead guilty. I, like most of the veterinarians I know, have radiographed at least one body part. I'm also a pro at wound care. Many of my colleagues have treated themselves with antibiotics or other pharmaceuticals, with varying degrees of success. More than a few use their ultrasounds freely (one of my friends became especially proficient during her pregnancy). I also know two humans who have been sutured by veterinarians. Yes, all concerned knew this was a bad idea, but the "patients" were both relatives of veterinarians, had no medical insurance, and refused to seek proper medical attention. I've seen the healed lacerations, and while I'm not condoning this behavior, my colleagues do nice work.

The distinction between a veterinarian treating himself (or a willing but crazy relative) vs. a physician or nurse treating an animal is that the veterinarian, of course, can consent to committing malpractice on himself. The animal suffers in silence.

5
Physician and Nurses
by rebelcat34 on 03/04/2010 11:07am

I totally agree with this article. We are right next door to a human hospital and a lot of our clients are the dreaded physicians and nurses. Unfortunately, they are the worst. They usually self medicate for a week prior to seeking our advice and, like your article suggests, it ends poorly for the poor animals.
We once had a client, a nurse, who's dog had broken its leg. Instead of contacting us and bringing the dog the us for treatment he decided to align the leg and splint it himself. Not only was the bone unaligned but the splint was too tight and had gotten soaked. He only brought the dog in because the home made splint was smelling ungodly and thought we could fix that. The poor dogs leg was half rotten inside the splint and we had to amputate the leg.
I know this story isn't as bad as yours but it is still a terrible situation. My own mother is a human nurse and has an 18 pound DLH. She doesn't want to take my or my veterinarians advice of weight loss on her pre-diabetic cat. She thinks that he is perfectly fine. The sad thing is her and my father are both diabetics and know the health risks that come with it.
How do I educate these people who think they know more than i do?

6
by Othersideofthefence on 06/28/2010 10:03pm

Interesting. I am a physician that treats humans (internal medicine), and I for one would never presume to tell my veterinarian what to do. I haven't the first clue about basic feline (obligate carnivore) physiology, and barely a clue about canine physiology, much less exotics. Sometimes I do have questions for my vet that perhaps a non-physician might not have, but I would imagine she's ok with some questions, I hope. I have a veterinarian friend I work with, and sometimes we run our own cases by each other. I ask her about my cat, she asks me about her blood pressure.

Honestly, there are difficult patients everywhere. We have a lot of human patients who don't think we know what we're talking about, want to self diagnose or treat, or have fixed, bizarre misconceptions about pathology and physiology. I bet if DVMs and MDs got together, we'd have lots of similar stories about difficult patients/clients. I could write a book about the ones I've seen.

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About fully vetted

Jennifer Coates, DVM

Photo of Dr Coates

Image credit: Jim Piraino

...graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms: Vet-Speak Deciphered for the Non-Veterinarian. Dr. Coates also writes short stories that focus on the strength and importance of the human-animal bond, and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and various species of pets.

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