Dr. Lee, I could not possibly agree more. In fact, I talked today with a woman who told me she had just spent about a thousand dollars in vet bills for her dog who had a bladder infection. This is really, IMHO, an awful lot for a UTI. Over a hundred was for another test to make sure the dog was alright after treatment. In human medicine it would be considered way out of line, in the absence of hospitalization, or recurrence of symptoms after treatment. This woman was upset and I don't blame her. Her vet may well find she does not return. We should all remember that that common things happen commonly. Good judgment is the most important thing of all, along with good communication about differential diagnosis and treatment options. More and more tests are not a good substitute for judgment and diagnostic skill.

I believe that my vet is a wonderful combination of all-of-the-above.

If I ask for a particular test, he might heartily agree or he might say, "We can certainly do it, but I feel sure the problem is ______ so there's really no need for you to spend the money."

Unless it's urgent, he will suggest a diagnostic test and tell me what they next step might be, depending on the results.

He also takes the invasiveness of the test into account as well as anesthesia risks and what the test will entail for the critter.

Only twice has he said, "If it were my cat, I would _______." When he says that, I know we really need to do whatever he is suggesting.

(I'm an old girl) and I have a great respect for the wisdom of old white guys (even dead white guys). Unfortunately, our society has taken a turn towards "if it's not established, it's probably better" in all manner of culture including (especially) education. Technology (and pet health insurance to pay for it) has changed Vet Medicine much like technology has changed human medicine. Don't get me wrong, I'm not ready to throw out antibiotics and wonders of medical technology, but the prudent use of same--with wisdom--is a rare find. When I find wisdom, it's usually in the old white guys--especially the over 50 crowd, who in my college years were considered 'the enemy".

When I look for a vet, I look for someone over 50. It's ok if they employ younger vets, but in my experience, age usually indicates more cultural sophistication, wisdom and compassion.

I'd love to - if I could find it.

If you can't post a URL here, would it be possible for you to email it to me?

Thanks so much!

Thanks so much, Dr. Lee.

Public Radio rocks and so do you!

Maybe it's because I live in a big city but many of our vets who are over the age of 50 are neither white nor male. I am sure Desmondsmom meant it somewhat tongue in cheek but I think the real story is, these vets of all stripes were trained and practiced in an era when a lot of diagnostics were prohibitive for various reasons - cost, delay in getting results or cost/availability of treatment. So they had to work with simpler and more step-by-step approaches.

Even so, I like going to a practice where there are both older and younger vets on staff. Best of both worlds.

The third type of vet pretty much administers vaccinations and does spay/neuters. My sister-in-law calls them "country vets" but I don't think that is the right term to use.

I've seen it a lot; they do not do blood work or run tests that other vets would. From cats whose owners surrendered them to me... their vet's records only showed weight and vaccination number even for elderly cats who were losing weight. One was told that the cat's kidneys "felt fine" but no blood was tested (the cat had kidney disease). Another completely missed hyperthyroidism. That really frustrates me when I experience or hear of vets like that.

We drive past three vet offices on the way to our regular vet practice. They are a combination of young and older vets, and we've been very pleased with all of them. They seem to share knowledge and advice with each other, and are well equipped with technology, so it's the best of both worlds.

I adore my vet! While he has the knowledge to be doing some stem cell work for arthritis treatment in animals he also is the one to tell me ... "The diarrhea could be a lot ... for now 24 hour fast and reintroduce food with boiled hamburg/chicken with rice ... plenty of water". He's gentle, strong, kind, of good humor, personable, and takes all the time needed to explain a situation to me ... in ENGLISH. I've been with him over 20 years and will be with him as long as he is in practice! Thank you Keith!

"Take, for example, your average dog with three to four days of diarrhea. Nowadays, new graduates will rattle off all the advanced tests that need to be done with a sick pet — complete blood count (CBC to look at the white blood cell count), biochemical panel (to look at the kidney and liver function), urinalysis, fecal, X-rays, ultrasound, etc. — all of which add up to a whopping financial cost, typically $500-$1,000. Old school veterinarians? They’d do a fecal and dispense an ant-diarrheal medication … for a whopping cost of $25-$50. And if it didn’t improve, then they’d offer the blood work and X-rays in a step-wise fashion."
DR. LEE, I BEG TO DIFFER WITH YOU. A SPECIALITY CLINIC NEVER RAN A CHEM PANEL, (UNTIL THEY FOUND OUR DOG IN LATERAL RECUMBANCY WITH WEAK PULSES). THE FAILED TO DO WHAT I WOULD REFER TO AS A MINIMUM DATABASE.
OUR HAD BEEN TAKEN TO THIS CLINIC FOR MELENA, WHICH HAD PERSISTED FOR SIX DAYS,(AND TWO APPOINTMENTS TO OUR GP) AND WHAT DID THEY DO? THEY REPEATED A CBC, FAILED TO COMPARE IT TO THE ONE WE HAND CARRIED, MISSED A PRECIPITIOUS DROP IN HEMATOCRIT, AND PRESCRIBED PANACURE AND METAMUCIL, IN SPITE OF THE FACT THAT OUR GP HAD ALREADY DONE A FECAL , WHICH WAS NEGATIVE. (AND OUR DOG WAS ON HEARTGUARD PLUS) THERE IS SOMETHING TO BE SAID FOR COMMON SENSE. BLOOD IS BLACK, IT IS DIGESTED BLOOD. YET A GASTRIC ULCER WAS NOT EVEN ON THE RADAR FOR THESE SO CALLED "SPECIALISTS"
YES, THERE IS SOMETHING TO BE SAID FOR OLD SCHOOL VETS. OUR VET SMELLS THE BREATH OF EACH PATIENT, CAREFULLY PALPATES, TAKES THOROUGH MEDICAL HISTORY, BUT MORE IMPORTANTLY LISTENS TO THE PET PARENT WHEN THE PET PARENT TELLS HIM THAT SOMETHING IS AMISS. MUCH OF THIS MISDIAGNOSIS, IN MY OPINION, WITH LESS EXPERIENCED VETS COMES DOWN TO HUBRIS.

While most medical doctors have lost the advanced skill of the physical examination (when was the last time your MD thoroughly palpated your abdomen?), it’s still a really important tool in veterinary medicine. And old school veterinarians are really good at the PE.

EVERY TIME THAT I HAVE A PHYSICAL. SHE NOT ONLY PALPATES MY ABDOMEN, SHE FOUND A THYROID NODULE. IT ISN'T BECOMING FOR YOU TO CRITICIZE MD'S WHEN YOUR OWN PROFESSION IS SORELY LACKING, DR. LEE. IT IS ALWAYS EASIER TO TRY TO BELITTLE MD'S THAN TO TAKE RESPONSIBLITY AND RECOGNIZE WHAT IS REALLY WRONG WITH YOUR PROFESSION.

1. YOU ARE PRICING YOURSELVES INTO OBLIVION
2. YOU DO NOT PUNISH OR REPRIMAND THOSE WHO
FAIL TO EXERCISE DUE DILIGENCE, INSTEAD,
YOU MAKE EXCUSES FOR THEM OR COVER FOR THEM.
3. YOU ARE DISINGENUOUS BECAUSE YOU FAIL TO
SUPPORT THE IDEA OF GRACIE'S LAW, YET YOU
REFER TO OUR PETS AS "FAMILY" WHEN IT SUITS
THE SELF SERVING MOTIVES OF YOUR PROFESSION.

BOTTOM LINE....GIVE ME AN OLD SCHOOL VET ANY DAY (AND THE SAME GOES FOR MD'S AS WELL) OVER SOMEONE FRESH OUT OF MED/VET SCHOOL WITH A BIG EGO AND A BIGGER SENSE OF ENTITELMENT.

Since Dr. Lee opened up the discussion of vets vs. MD's, it's clear that there's some "class envy" on her part regarding the salary of an MD vs. the salary of vet. Judging by the home of the owner of the specialty clinic, as well as by the comments that he made to a neighbor, who happened to be a mutual business acquaintance, some vets (specialists, Dr. Lee) earn much more than some MD's. The owner of the specialty clinic constantly bragged to his neighbor about the $$ he was raking in, and not once did he mention the quality of the care rendered.
Now, let's make some comparisons between MD's and vets, based upon my over 25 years of experience of dealing with both.



1. Most MD's work much longer hours. Yet, in spite of that, I have had MD's call me at home, numerous times, to discuss questions that I had , regarding my father's care, my mother's care, my husband's care. They have called after hours, during office hours, and one has trusted me enough to give me his email address. Yet, I have never had a vet say to me, "If you have a problem at home, you can email me, or "here's my cell phone number,

if you need it." I have had physicians do just that.



2. A surgeon made a grave error in judgment, and after the surgery was over, he apologized to my father, face to face, with me and my mother in the room. He took responsiblity for his error. When our dog died due to what we believe was vet negligence, no one took responsiblity. As a matter of face, the surgeon and the non specialist in charge of her case would not even speak to me or respond to any questions. One vet, who was not even heavily

involved in the case, took over as the PR person, and shielded the others from contact with me and my husband.



3. I have had one special physician call me while I was on the way to the ER with my husband. He not only helped me by speaking to me, he actually spoke to the ER physican on my behalf. He had answered numerous medical questions by email, and he has treated me like a member of his own family, as a sister. I have never seen that from a vet.



4. My own physican called me at length, after hours, from her home, because she was worried about me worrying about recent health problems. She spoke at length with me and called me simply because she was concerned about me. I could not even get a phone call during the night regarding our dog's medical condition once she was hospitalized at the "speciality" clinic, because as we learned at trial, there was no vet on the premises.



5. My allergist and I were discussing the stress that I am under given my own health problems, and those of my husband and my elderly mother, who lives alone, 40 min. away, on the other end of town, and whom I visit and transport at least three times per week. We also discussed the incoming medical bills with all of the recent hospital stays, tests, etc. and he said, "Just what you need, more stress." I believe that it was out of the goodness of his heart that he only charged me a VERY nominal fee of $52, and he is an MD, Dr. Lee, you know, one of those people you vilify for their greed. I have yet to get out of the vet's office with a bill that low, unless I am only picking up lactated rings and venostats for our two cats' sub-q fluids. So, you'd best think before you berate an entire profession, as your own profession is not so red hot. The specialty clinic's bills were out of sight, but we obviously would have paid anything to get help (which eluded us do to their ineptitude) for our dog.



There are very few Dr. Ken's in this world, and in fairness to him, I know that he charges less than most vets, and if I've had a question about our cats, he has gladly answered it and asked for nothing in return, simply because he is that "old school vet" that you claim to have learned from.

6. Do you honestly think that an MD who beat to death a patient, as has been done by some vets, could still hold a license to practice medicine? Yet, this has been done on more than one occassion, and those responsible for the death of their patient at their own malicious hands, are still able to practice veterinary medicine.



Most of my physicians are well over the age of 40, and some are in their late 50's and early 60's. Their mindset is different. They, like most of the old school vets, are in their profession for the RIGHT reasons....because they are healers, and they want to help. They take their Hippocratic oath seriously, just as the old school vets take their oath more seriously as well. You would do well to study them more closely, Dr. Lee, as they are a dying breed, and it is people like you who will see the demise of veterinary medicine due to avarice and misplaced values.




"If having a soul means being able to feel love and loyalty and gratitude, then animals are better off than a lot of humans" ~ James Herriot

31VETS VS. MDby caveatemptor on 04/14/2012 11:41amWhen my father was alive, he had to have a bone marrow Bx , and the physican actually allowed and ENCOURAGED my mother and I to sit in the procedure room with my father to help to allay my father's fears. In the specialty clinic, our dog was never examined in our presence, and she was "whisked" away to the back, where we had no idea what was going on, nor could we ask any questions nor point out anything that we felt might have been missed, or needed more attention, during the exam.

The only vet that I can honestly say who has treated me as a member of his family is Dr. Ken. Even though he has never treated either of our babies, we have a common bond in the loss of our beloved pet kids, Gracie and Peach.
He knows what is like to experience that kind of loss, and he is courageous to take on his entire profession in order to do what is right. His goal was the same as our goal in court...to see that the human/animal bond is recognized in a court of law and that companion animals, even cats, Dr. Coates, have intrinsic value. Yes, Dr. Lee, I know that you wrote this article, but if was Dr. Coates very uncompassionate and inaccurate statements about cats that prompted another firestorm from the readers of her blog.