Straddling the thorny divide between public health and pet medicine
Whether you’re a veterinary surgeon or an human oncologist, you rarely have to handle the touchy topic of public health. General practitioners however––regardless of species––are constantly tasked with taking the long view when treating our patients:
How might our patients’ conditions potentially affect the health of others? Which prevention techniques and tests are in the best interest of the population at large? How might these affect our individual patient’s health/psyche/stress levels? Our client’s pocketbooks?
They’re all issues we have to weigh as risks/downsides against the potential public health benefits of our medical decisions. Consider...
- infectious disease testing,
- parasite examinations,
For veterinary GPs, the problem is even more prickly: It’s not enough to focus in on the details of our patients’ individual conditions and the risks to their conspecifics, we’re also charged with gatekeeping detail when it comes to issues surrounding the health and well being of humans. Consider...
- Lyme disease,
- Hanta virus,
After last week’s rabies debate, I couldn’t help but let my mind wander to this topic. After all, few non-veterinarians understand how it is that we’re required, by oath, to treat human public health and individual patient care on an equal footing.
Too often, the public at large assumes that veterinarians enter this profession to remain among animals...because humans are annoying or difficult or disgusting...and, of course, because animals are innocent and wonderful. There’s something exalted about us that we would prefer to minister to the defenseless of the word, it’s largely assumed.
While this may be the case when we initially elect to pursue this profession, most veterinary students soon learn that most of veterinary medicine is about human-human interactions and lots of public health training. Whether we as veterinarians accept this mission or not, there’s no mistaking the fact that our schools fully disclosed this expectation from the very first moment our butts hit those chairs.
That’s why I’ve got to admit I was a bit put out by the first comment that followed my USA Today column on rabies.
“I love how the whole thing is about having people get their pets vaccinated against rabies...so they don't get it themselves. Get the animals the vaccine so their poor, poor owners won't get it? How about getting the vaccine so the animals don't get it? Some veterinari[a]n. A vet's only concern should be for the animal, if humans mean more than you should be a doctor instead.”
Hmmm...I never thought I’d be accused of being overly concerned about human health (or of not being a doctor, for that matter) but I get the point. (Ouch!) And isn’t it the same one so many of you have been making in your comments under last Thursday’s rabies post? I mean, why should any veterinarian force the rabies vaccine issue (or, indeed, any cross-species, health-based initiative) if our patients are truly the first priority?
I guess that’s because the truth is...they’re not. They share that distinction––evenly––with all of you. And striking that balance is a lot harder to manage than you might expect. Especially when our sympathies might reasonably be expected to lie with the patients immediately before us.
Unpopular though this position might be, sometimes I think veterinarians need to be seen for what we’re supposed to be: gatekeepers of the one human medical domain MDs can’t possibly command without firsthand knowledge of veterinary patient care.
And if that doesn’t appeal to those among you who would expect veterinarians to possess a blind devotion to animal well being, consider that you wouldn’t much like us if we took that position to sociopathic extremes. After all, we’re only human, too.
For today's DailyVet post over on PetMD, brush up on the mandatory spay/neuter debate.