Most animals I see are referred to me by their primary care veterinarian, and since cancer tends to occur in older dogs and cats, many of these pets have been seen by the same doctor from the time of their very first vaccines as a puppy or kitten. Given my inherent lack of a similarly established long-term relationship, I’m continually astonished at the level of trust owners have in my opinion of their pet’s condition.
A further complicating fact is that most owners we see truly identify their pet as a part of their family, and many refer to them as their children (even those who have actual children will do so). I am also typically introducing myself during an emotionally charged time period, which I anticipate would be a set-up for more episodes of skepticism than I typically encounter. Yet, with few exceptions, a bond is established quickly and efficiently; something I’ve yet to take for granted.
Both my husband and I have experienced a few minor health issues ourselves over the past few months, and I can easily compare my trust in the human medical system to that experienced by pet owners. When a person in a white lab coat is telling you something, whether related to your own health, a loved one’s health, or your pet, you will listen. Often this may be ironically compounded when you may not understand every word being uttered or test being recommended.
Medical jargon is scary and foreign, even to those of us trained in its meaning and with an understanding of anatomy and physiology. When you are on the other side of the exam table, I believe it allows you to comprehend this in a different way.
I suppose given some of the limitations on the “bedside” manner aspect of human doctors, I strive for a higher standard and I have contemplated some of the reasons why it is that I’m able to form a connection in such a rapid fashion. I think what’s most astonishing to me as that I feel the majority of the “work” we put into connecting with owners comes during the time after they have left the exam room.
My new appointments are scheduled for one hour, and during that time I will discuss a great deal with owners, generally covering what I describe as, “What we know, what we don’t know, and the things we can do to bridge the gap.” Though owners may arrive prepared with their own research, most are eager to hear the information I present, are attentive to detail, and ask insightful questions about available options.
In the realm of medical appointments, an hour may seem near eternity, yet simultaneously in the larger scale of the relationship between an owner and his or her pet, it’s a mere nanosecond of time. The time I have to establish a connection with owners and their pets isn’t nearly enough time.
Often consults run longer than an hour, and even more frequently my correspondence with an owner is not limited to the face time experienced during our initial meeting. Most owners will call and/or e-mail follow-up questions, or I’m calling them to discuss test results within a day or so after meeting them. This accessibility is one aspect separating specialty veterinarians from our human counterparts.
We also often proactively call owners to check up on patients or to follow up on previous concerns. This is done out of genuine concern for the welfare of our cases; we sincerely worry about our patients when they are not directly under our care. Yet, I am somewhat shocked if my own doctor gives the same service, and cynical in thinking their inquiry is likely more related to making sure my co-pay was delivered.
Sometimes the level of confidence I’m given borders on becoming overwhelming. It’s difficult to remember when an owner calls with a question we might consider somewhat self-evident that they are doing so because they are so dedicated to their pet’s care and because they value our stance on their issue. Some issues are more controversial (e.g., those related to vaccination or what food to feed), while others seem more innocuous (e.g., those related to walking on grass versus concrete or whether it’s OK to continue brushing their teeth). Either way, I’m their “go-to” person for things they likely never afforded much consideration prior to their pet’s life with cancer.
Reciprocally, an owner should realize it places a tremendous amount of pressure on me to have an opinion on something I may not truly have expertise in. I know I am limited in my knowledge of areas such as nutrition and supplements, but this also instills a desire to continue to further the depth and breadth of my own education and truly forces me to keep current on all aspects of veterinary oncology — not just those related to my typical day-to-day activities.
Perhaps I shouldn’t feel so astonished at the faith instilled in me by owners, but rather see it as a sign that my work is valued and appreciated. I feel humbled by their acceptance, yet simultaneously empowered by their sureness. Whether I truly deserve their reliance is another issue altogether, I suppose.
An endeavor I think I’m pretty happy to try and prove.
Dr. Joanne Intile