What the heck is evidence-based veterinary medicine and why should I care?
It’s a weird topic—and a potentially boring one—but one that has implications for how humans and animals are treated in medical settings.
Do you ever wonder how it is that vets decide which drugs to give and what procedures to undertake when an animal is ill? What we should do is read, read and read. Studies done by respected individuals, reviewed by other respected individuals and then published in respected journals is how it should be done.
But we have such limited time (families, patients, clients, real life…) that sometimes we go on “vacation” just to brush up (conferences, beach-reading, nights out with the local luminaries…). So sometimes it’s the books (often several years old) and the Internet vet chat rooms (often a lot of “this-is-what-I-do-and-it-works-for-me” kind of stuff).
And that’s what a lot of human docs do, too. We’re real people, after all. Sure, some of us read faster, memorize better, work harder, but none of us is perfect (right now I’m staring at a stack of journals I should be reading but, instead, I’m typing).
This is where places like Banfield do a pretty good job. They come up with “protocols,” based on the most recent research, and push their vets to implement them. They then use the information gleaned from databased reports on how patients recovered (or didn’t) and use them for future protocols. (They also use this info to determine which practices are more profitable, so they’re not so lily-white in their approach—their info just happens to serve a dual purpose.)
This is called “evidence-based” medicine (sans the profit motive, of course): using hard facts and good studies to support taking a certain tack in treating diseases (as opposed to the “I-do-it-this-way-because-I’ve-always-done-it-like-that” approach.
But that’s not so easy to do as it sounds. It’s like forcing yourself to go to the gym when you’d rather go home and curl into a ball on your sofa in front of the television. It’s not just about reading the journals, it’s about changing your practices when you’re sometimes too busy to think straight, much less suffer the stress of giving a new anesthetic when you’ve got to get out in forty-five minutes to take your kid to the orthodontist. How’s that for real life?
If I worked at Banfield I might not have to think about implementing new protocols—it’d be part of my job to follow cookbooked procedures I might otherwise have overlooked when left to my own devices. So there’s something to be said for the Banfield way—even if it’s not my style. (I guess I just don’t like being told what to do.)
Practicing medicine based on real science is a basic part of any medical professional’s training and ongoing practice. But practicing medicine is more than just protocols and procedures any trained monkey could mimic. It’s about looking for, finding, assessing and selectively implementing. And that’s where the art is. Because, ultimately, how it’s done is often more important than what gets done.
Libra that I am, I believe it’s all about having the right balance of both approaches. The whats and hows of medicine are equally odious in either extreme.